Document Detail


Effect of Therapeutic Hyperoxia on Maximal Oxygen Consumption and Perioperative Risk Stratification in Chronic Obstructive Pulmonary Disease.
MedLine Citation:
PMID:  22249909     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Maximal consumption of oxygen [Formula: see text]O(2)max) during exercise is used in patients with chronic obstructive pulmonary disease (COPD) to stratify perioperative risk. However, the impact of therapeutic hyperoxia (i.e., use of supplemental oxygen to prevent hypoxemia during exercise) on [Formula: see text]O(2)max and other ventilatory parameters during maximal exercise in the resting normoxic COPD population is poorly defined. METHODS: A randomized, double-blind crossover study was performed in which resting normoxic subjects (n = 16) with COPD underwent two standard symptom-limited, ramped-protocol bicycle ergometry cardiopulmonary exercise tests >5 days apart with FiO(2) of 0.21 (control) and ~0.28 (therapeutic hyperoxia). [Formula: see text]O(2)max and other ventilatory parameters were compared using a paired two-sample t-test. RESULTS: Therapeutic hyperoxia significantly increased [Formula: see text]O(2)max (12.2 ± 2.9 vs. 13.6 ± 3.8 ml/kg/min, P = 0.03), partial pressure of end-tidal carbon dioxide, and oxygen saturation and significantly decreased [Formula: see text]E-[Formula: see text]CO(2) slope, but it did not affect exercise time, maximum watts achieved, maximum minute ventilation, or change in end-expiratory lung volume. Three of four subjects with [Formula: see text]O(2)max <10 ml/kg/min without supplemental oxygen increased [Formula: see text]O(2)max to ≥10 ml/kg/min on therapeutic hyperoxia and potentially changed perioperative risk category. CONCLUSIONS: Therapeutic hyperoxia in a resting normoxic COPD population significantly improves [Formula: see text]O(2)max and may change perioperative risk stratification by conventional criteria. Further studies are needed to determine if this change in stratification is appropriate.
Authors:
Hilary M Womble; Richard M Schwartzstein; Richard P Johnston; David H Roberts
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-17
Journal Detail:
Title:  Lung     Volume:  -     ISSN:  1432-1750     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7701875     Medline TA:  Lung     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA, 02215, USA, hwomble@bidmc.harvard.edu.
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