| Below what FEV1 should arterial blood be routinely taken to detect chronic respiratory failure in COPD? | |
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MedLine Citation:
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PMID: 21497004 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: To diagnose and assess chronic respiratory failure in stable chronic obstructive pulmonary disease (COPD) the measurement of arterial blood gases (ABG) is required. It has been suggested that ABG be determined for this purpose when FEV1 ranges between 50% and 30% predicted, but these thresholds are not evidence-based. OBJECTIVE: To identify the post-bronchodilator (BD) FEV(1) and arterial oxygen saturation (SaO(2)) values that provide the best sensitivity, specificity, and likelihood ratio (LR) for the diagnosis of hypoxaemic and/or hypercapnic chronic respiratory failure in stable COPD. METHODS: A total of 150 patients were included (39 with PaO(2) < 60 mmHg [8 kPa], 14 of them with a PaCO(2) ≥ 50 mmHg [6.7 kPa]). The best post-BD FEV(1) and SaO(2) cut-off points to predict chronic respiratory failure were selected using the PC and the Receiver Operating Characteristics (ROC) curves. RESULTS: A post-BD FEV(1) equal to 36% and an SaO(2) of 90% were the best predictive values for hypoxaemic respiratory failure and a post-BD FEV(1) equal to 33% for the hypercapnic variant. An FEV(1) ≥ 45% ruled out hypoxaemic respiratory failure. CONCLUSION: A post-BD FEV(1) of 36% is the best cut-off point to adequately predict both hypoxaemic and hypercapnic respiratory failure in the patient with stable COPD. For its part, an SaO(2) of 90% is the best value for isolated hypoxaemic failure. These values could be considered for future clinical recommendations/guidelines for COPD. |
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Authors:
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Diego A Rodríguez; Lluis Jover; Mitra B Drakulovic; Federico P Gómez; Josep Roca; Joan Albert Barberà; Peter D Wagner; Roberto Rodríguez-Roisin |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-13 |
Journal Detail:
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Title: Archivos de bronconeumologia Volume: - ISSN: 1579-2129 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0354720 Medline TA: Arch Bronconeumol Country: - |
Other Details:
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Languages: ENG; SPA Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2010 SEPAR. Published by Elsevier Espana. All rights reserved. |
Affiliation:
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Servei de Pneumologia (Institut Clinic del Tòrax), Hospital Clínic, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat de Barcelona (UB), Barcelona, España. |
Vernacular Title:
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¿Cuál es el mejor FEV(1) para detectar insuficiencia respiratoria crónica en la EPOC estable? |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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