Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study
<p>Abstract</p> <p>Background</p> <p>The ability to objectively differentiate exacerbations of chronic obstructive pulmonary disease (COPD) from day-to-day symptom variations would be an important development in clinical practice and research. We assessed the ability of...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2010-10-01
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| Series: | BMC Pulmonary Medicine |
| Online Access: | http://www.biomedcentral.com/1471-2466/10/52 |
| _version_ | 1818385796274585600 |
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| author | Goldring James JP Quint Jennifer K Donaldson Gavin C Hurst John R Patel Anant RC Wedzicha Jadwiga A |
| author_facet | Goldring James JP Quint Jennifer K Donaldson Gavin C Hurst John R Patel Anant RC Wedzicha Jadwiga A |
| author_sort | Goldring James JP |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The ability to objectively differentiate exacerbations of chronic obstructive pulmonary disease (COPD) from day-to-day symptom variations would be an important development in clinical practice and research. We assessed the ability of domiciliary pulse oximetry to achieve this.</p> <p>Methods</p> <p>40 patients with moderate-severe COPD collected daily data on changes in symptoms, heart-rate (HR), oxygen saturation (SpO<sub>2</sub>) and peak-expiratory flow (PEF) over a total of 2705 days. 31 patients had data suitable for baseline analysis, and 13 patients experienced an exacerbation. Data were expressed as multiples of the standard deviation (SD) observed from each patient when stable.</p> <p>Results</p> <p>In stable COPD, the SD for HR, SpO<sub>2 </sub>and PEF were approximately 5 min<sup>-1</sup>, 1% and 10l min<sup>-1</sup>. There were detectable changes in all three variables just prior to exacerbation onset, greatest 2-3 days following symptom onset. A composite Oximetry Score (mean magnitude of SpO<sub>2 </sub>fall and HR rise) distinguished exacerbation onset from symptom variation (area under receiver-operating characteristic curve, AUC = 0.832, 95%CI 0.735-0.929, p = 0.003). In the presence of symptoms, a change in Score of ≥1 (average of ≥1SD change in both HR and SpO<sub>2</sub>) was 71% sensitive and 74% specific for exacerbation onset.</p> <p>Conclusion</p> <p>We have defined normal variation of pulse oximetry variables in a small sample of patients with COPD. A composite HR and SpO<sub>2 </sub>score distinguished exacerbation onset from symptom variation, potentially facilitating prompt therapy and providing validation of such events in clinical trials.</p> |
| first_indexed | 2024-12-14T03:43:51Z |
| format | Article |
| id | doaj.art-2f36dafb5959439ab119afeceede5a75 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-14T03:43:51Z |
| publishDate | 2010-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-2f36dafb5959439ab119afeceede5a752022-12-21T23:18:24ZengBMCBMC Pulmonary Medicine1471-24662010-10-011015210.1186/1471-2466-10-52Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot studyGoldring James JPQuint Jennifer KDonaldson Gavin CHurst John RPatel Anant RCWedzicha Jadwiga A<p>Abstract</p> <p>Background</p> <p>The ability to objectively differentiate exacerbations of chronic obstructive pulmonary disease (COPD) from day-to-day symptom variations would be an important development in clinical practice and research. We assessed the ability of domiciliary pulse oximetry to achieve this.</p> <p>Methods</p> <p>40 patients with moderate-severe COPD collected daily data on changes in symptoms, heart-rate (HR), oxygen saturation (SpO<sub>2</sub>) and peak-expiratory flow (PEF) over a total of 2705 days. 31 patients had data suitable for baseline analysis, and 13 patients experienced an exacerbation. Data were expressed as multiples of the standard deviation (SD) observed from each patient when stable.</p> <p>Results</p> <p>In stable COPD, the SD for HR, SpO<sub>2 </sub>and PEF were approximately 5 min<sup>-1</sup>, 1% and 10l min<sup>-1</sup>. There were detectable changes in all three variables just prior to exacerbation onset, greatest 2-3 days following symptom onset. A composite Oximetry Score (mean magnitude of SpO<sub>2 </sub>fall and HR rise) distinguished exacerbation onset from symptom variation (area under receiver-operating characteristic curve, AUC = 0.832, 95%CI 0.735-0.929, p = 0.003). In the presence of symptoms, a change in Score of ≥1 (average of ≥1SD change in both HR and SpO<sub>2</sub>) was 71% sensitive and 74% specific for exacerbation onset.</p> <p>Conclusion</p> <p>We have defined normal variation of pulse oximetry variables in a small sample of patients with COPD. A composite HR and SpO<sub>2 </sub>score distinguished exacerbation onset from symptom variation, potentially facilitating prompt therapy and providing validation of such events in clinical trials.</p>http://www.biomedcentral.com/1471-2466/10/52 |
| spellingShingle | Goldring James JP Quint Jennifer K Donaldson Gavin C Hurst John R Patel Anant RC Wedzicha Jadwiga A Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study BMC Pulmonary Medicine |
| title | Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study |
| title_full | Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study |
| title_fullStr | Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study |
| title_full_unstemmed | Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study |
| title_short | Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study |
| title_sort | domiciliary pulse oximetry at exacerbation of chronic obstructive pulmonary disease prospective pilot study |
| url | http://www.biomedcentral.com/1471-2466/10/52 |
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