In:
Respirology, Wiley, Vol. 24, No. 3 ( 2019-03), p. 262-269
Abstract:
Chronic respiratory failure (CRF) with hypoxaemia is an important pathophysiology in patients with chronic obstructive pulmonary disease (COPD), and existing mild hypoxaemia may be a sign of future CRF development. However, little is known about the trajectory of partial arterial pressure of oxygen (PaO 2 ) decline in patients with COPD. We assessed decline in PaO 2 and the impact of short‐term reductions in PaO 2 to predict future decline in PaO 2 . Methods A total of 172 outpatients with COPD from a prospective cohort study were enrolled. Pulmonary function tests and arterial blood gas (ABG) analyses were conducted at baseline and 1 year after enrolment and changes in PaO 2 (ΔPaO 2 ) and other parameters were calculated. Survival and incidence of CRF (as assessed by prescription of long‐term home oxygen therapy) were monitored for 6 years. Results A total of 164 patients completed the observation period and 101 patients had mild hypoxaemia (PaO 2 〈 80 Torr) at baseline. No patients with normal PaO 2 (≥80 Torr) developed CRF, and 10 patients with mild hypoxaemia developed CRF in 6 years. Baseline airflow limitation and diffusion capacity were significantly associated with development of CRF. Receiver‐operating characteristic curve analysis showed that ΔPaO 2 of −3.05 Torr/year is a useful cut‐off value to predict development of CRF in 6 years (hazard ratio (HR): 12.6, 95% CI: 3.48–58.73, P 〈 0.0001). Conclusion Patients with COPD and mild hypoxaemia may benefit from repeat ABG after 1 year. Although PaO 2 trajectories widely varied, significant annual changes in PaO 2 of at least −3.0 Torr/year were predictive of CRF development.
Type of Medium:
Online Resource
ISSN:
1323-7799
,
1440-1843
DOI:
10.1111/resp.2019.24.issue-3
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2010720-1
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