Document Detail


Outcome of COPD patients with mild daytime hypoxaemia with or without sleep-related oxygen desaturation.
MedLine Citation:
PMID:  11488315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of the present study was to compare the evolution of pulmonary haemodynamics and of arterial blood gases in chronic obstructive pulmonary disease (COPD) patients with mild-to-moderate hypoxaemia, with or without sleep-related oxygen desaturation. COPD patients with daytime arterial oxygen partial pressure in the range 56-69 mmHg were included prospectively. Sleep-related oxygen desaturation was defined as spending > or = 30% of the nocturnal recording time with arterial oxygen saturation <90%. From the 64 patients included, 35 were desaturators (group 1) and 29 were nondesaturators (group 2). At baseline (t0), patients with sleep-related desaturation had a significantly higher daytime (mean +/- SD) arterial carbon dioxide partial pressure (Pa,CO2) (44.9 +/- 4.9 mmHg versus 41.0 +/- 4.1 mmHg, p=0.001) whereas mean pulmonary artery pressure (mPAP) was similar in the two groups. After 2 yrs (t2) of follow-up, 22 desaturators and 14 nondesaturators could be re-evaluated, including pulmonary haemodynamic measurements. None of the nondesaturator patients became desaturators at t2. The difference between the two groups in terms of daytime Pa,CO2 was still present at t2. The mean changes in mPAP from t0 to t2 were similar between the two groups, as were the rates of death or requirement for long-term oxygen therapy (American Thoracic Society criteria) during follow-up of up to 6 yrs. The presence of sleep-related oxygen desaturation is not a transitional state before the worsening of daytime arterial blood gases, but is a characteristic of some chronic obstructive pulmonary disease patients who have a higher daytime arterial carbon dioxide partial pressure. Such isolated nocturnal hypoxaemia or sleep-related worsening of moderate daytime hypoxaemia does not appear to favour the development of pulmonary hypertension, nor to lead to worsening of daytime blood gases.
Authors:
A Chaouat; E Weitzenblum; R Kessler; R Schott; C Charpentier; P Levi-Valensi; J Zielinski; L Delaunois; R Cornudella; J Moutinho dos Santos
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology     Volume:  17     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-08-07     Completed Date:  2002-01-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  848-55     Citation Subset:  IM    
Affiliation:
Dept of Pneumology, University Hospital, Strasbourg, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anoxia / diagnosis*,  etiology,  physiopathology
Carbon Dioxide / blood
Circadian Rhythm / physiology
Female
Follow-Up Studies
Hemodynamics / physiology
Humans
Lung / blood supply
Male
Middle Aged
Oxygen / blood
Polysomnography
Pulmonary Disease, Chronic Obstructive / diagnosis*,  physiopathology
Sleep Apnea Syndromes / diagnosis*,  etiology,  physiopathology
Sleep Stages / physiology
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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