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Title: | Short-term Effects of Supplemental Oxygen on 6-Min Walk Test Outcomes in Patients With COPD A Randomized, Placebo-Controlled, Single-blind, Crossover Trial | Authors: | Jarosch, Inga Gloeckl, Rainer Damm, Eva Schwedhelm, Anna-Lena Buhrow, David Jerrentrup, Andreas SPRUIT, Martijn A. Kenn, Klaus |
Issue Date: | 2017 | Publisher: | AMER COLL CHEST PHYSICIANS | Source: | CHEST, 151(4), p. 795-803 | Abstract: | BACKGROUND: The acute effect of supplemental oxygen during exercise has been shown to differ largely among patients with COPD. It is unknown what factors influence oxygen response. METHODS: In a randomized, single-blind fashion, 124 patients with COPD underwent one 6-min walk test on supplemental oxygen (6MWT(O2)) and one 6-min walk test on room air after a practice 6-min walk test. Both gases were delivered via standard nasal prongs (2 L/min). For analyses, patients were stratified on the basis of PaO2 values and compared: (1) 34 patients with resting hypoxemia (HYX); (2) 43 patients with exercise-induced hypoxemia (EIH); and (3) 31 patients with normoxemia (NOX). RESULTS: Oxygen supplementation resulted in an increase in the 6-min walk distance in the total cohort (27 +/- 42 meters; P < .001) and in the subgroups of HYX (37 +/- 40 meters; P < .001) and EIH (28 +/- 44 meters; P < .001) but not in the NOX subgroup (15 +/- 43 meters; P = .065). Forty-two percent of patients with HYX and 47% of patients with EIH improved their 6-min walk distance to a clinically relevant extent (>= 30 meters) by using oxygen. These oxygen responders were characterized by significantly lower 6-min walk distance using room air compared with patients without a relevant response (306 +/- 106 meters vs 358 +/- 113 meters; P < .05). Although oxygen saturation was significantly higher during 6MWT(O2) compared with the 6-min walk test on roomair in all 3 subgroups, it dropped to < 88% during 6MWT(O2) in 73.5% of patients with HYX. CONCLUSIONS: In contrast to patients with NOX, patients with HYX and EIH generally benefit from supplemental oxygen by increasing exercise capacity. However, less than one-half of patients reached the threshold of clinically relevant improvements. These oxygen responders were characterized by significantly lower exercise capacity levels. | Notes: | [Jarosch, Inga; Gloeckl, Rainer; Kenn, Klaus] Schoen Klin Berchtesgadener Land, Dept Resp Med & Pulm Rehabil, Malterhoeh 1, D-83471 Schoenau Koenigssee, Germany. [Gloeckl, Rainer] Tech Univ Munich, Klinikum Rechts Isar, Dept Prevent Rehabil & Sports Med, Munich, Germany. [Damm, Eva; Schwedhelm, Anna-Lena; Buhrow, David; Jerrentrup, Andreas] Univ Marburg, Dept Pneumol & Crit Care Med, Marburg, Germany. [Spruit, Martijn A.] Ctr Expertise Chron Organ Failure, CIRO, Dept Res & Educ, Horn, Netherlands. [Spruit, Martijn A.] Hasselt Univ, Fac Med & Life Sci, REVAL Rehabil Res Ctr, BIOMED Biomed Res Inst, Diepenbeek, Belgium. [Spruit, Martijn A.] Maastricht Univ, Med Ctr, NUTRIM Sch Nutr & Translat Res Metab, Dept Resp Med, Maastricht, Netherlands. [Kenn, Klaus] Univ Marburg, Dept Pulm Rehabil, Marburg, Germany. | Keywords: | 6-min walking distance; COPD; exercise-induced hypoxemia; exercise testing; supplemental oxygen;6-min walking distance; COPD; exercise-induced hypoxemia; exercise testing; supplemental oxygen | Document URI: | http://hdl.handle.net/1942/24117 | ISSN: | 0012-3692 | e-ISSN: | 1931-3543 | DOI: | 10.1016/j.chest.2016.11.044 | ISI #: | 000398731500021 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2018 |
Appears in Collections: | Research publications |
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manuscript.pdf | Peer-reviewed author version | 484.08 kB | Adobe PDF | View/Open |
PIIS0012369216625722.pdf Restricted Access | Published version | 411.28 kB | Adobe PDF | View/Open Request a copy |
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