Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease
Background Fibrotic interstitial lung disease (ILD) is frequently associated with abnormal oxygenation; however, little is known about the accuracy of oxygen saturation by pulse oximetry (SpO2) compared with arterial blood gas (ABG) saturation (SaO2), the factors that influence the partial pressure...
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Format: | Article |
Language: | English |
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BMJ Publishing Group
2024-07-01
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Series: | BMJ Open Respiratory Research |
Online Access: | https://bmjopenrespres.bmj.com/content/11/1/e002250.full |
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author | Deborah Assayag Julie Morisset Jolene H Fisher Hélène Manganas Christopher J Ryerson Martin Kolb Kerri Johannson Mira A Donaldson Kathryn Donohoe Celine Durand Stacey D Lok Veronica Marcoux Bohyung Min Daniel-Costin Marinescu |
author_facet | Deborah Assayag Julie Morisset Jolene H Fisher Hélène Manganas Christopher J Ryerson Martin Kolb Kerri Johannson Mira A Donaldson Kathryn Donohoe Celine Durand Stacey D Lok Veronica Marcoux Bohyung Min Daniel-Costin Marinescu |
author_sort | Deborah Assayag |
collection | DOAJ |
description | Background Fibrotic interstitial lung disease (ILD) is frequently associated with abnormal oxygenation; however, little is known about the accuracy of oxygen saturation by pulse oximetry (SpO2) compared with arterial blood gas (ABG) saturation (SaO2), the factors that influence the partial pressure of carbon dioxide (PaCO2) and the impact of PaCO2 on outcomes in patients with fibrotic ILD.Study design and methods Patients with fibrotic ILD enrolled in a large prospective registry with a room air ABG were included. Prespecified analyses included testing the correlation between SaO2 and SpO2, the difference between SaO2 and SpO2, the association of baseline characteristics with both the difference between SaO2 and SpO2 and the PaCO2, the association of baseline characteristics with acid-base category, and the association of PaCO2 and acid-base category with time to death or transplant.Results A total of 532 patients with fibrotic ILD were included. Mean resting SaO2 was 92±4% and SpO2 was 95±3%. Mean PaCO2 was 38±6 mmHg, with 135 patients having PaCO2 <35 mmHg and 62 having PaCO2 >45 mmHg. Correlation between SaO2 and SpO2 was mild to moderate (r=0.39), with SpO2 on average 3.0% higher than SaO2. No baseline characteristics were associated with the difference in SaO2 and SpO2. Variables associated with either elevated or abnormal (elevated or low) PaCO2 included higher smoking pack-years and lower baseline forced vital capacity (FVC). Lower baseline lung function was associated with an increased risk of chronic respiratory acidosis. PaCO2 and acid-base status were not associated with time to death or transplant.Interpretation SaO2 and SpO2 are weakly-to-moderately correlated in fibrotic ILD, with limited ability to accurately predict this difference. Abnormal PaCO2 was associated with baseline FVC but was not associated with outcomes. |
first_indexed | 2024-04-25T00:08:10Z |
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id | doaj.art-7e2f02956af44aa88ec56c1a83e4b1df |
institution | Directory Open Access Journal |
issn | 2052-4439 |
language | English |
last_indexed | 2025-03-21T03:58:30Z |
publishDate | 2024-07-01 |
publisher | BMJ Publishing Group |
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series | BMJ Open Respiratory Research |
spelling | doaj.art-7e2f02956af44aa88ec56c1a83e4b1df2024-07-29T22:00:10ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392024-07-0111110.1136/bmjresp-2023-002250Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung diseaseDeborah Assayag0Julie Morisset1Jolene H Fisher2Hélène Manganas3Christopher J Ryerson4Martin Kolb5Kerri Johannson6Mira A Donaldson7Kathryn Donohoe8Celine Durand9Stacey D Lok10Veronica Marcoux11Bohyung Min12Daniel-Costin Marinescu13Department of Medicine, McGill University, Montreal, Québec, CanadaDépartement de Médecine, Centre de Recherche du Centre Hospitalier de l`Universite de Montreal, Montreal, Québec, CanadaDepartment of Medicine, University of Toronto, Toronto, Ontario, CanadaDépartement de Médecine, Centre de Recherche du Centre Hospitalier de l`Universite de Montreal, Montreal, Québec, CanadaMedicine, The University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Medicine, McMaster University, Hamilton, Ontario, CanadaDepartment of Medicine, University of Calgary, Calgary, Alberta, CanadaDepartment of Medicine, The University of British Columbia, Vancouver, British Columbia, CanadaCollege of Medicine, University of Cincinnati, Cincinnati, Ohio, USADépartement de Médecine, Centre de Recherche du Centre Hospitalier de l`Universite de Montreal, Montreal, Québec, CanadaDepartment of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaDepartment of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaDepartment of Medicine, University of Calgary, Calgary, Alberta, CanadaDepartment of Medicine, The University of British Columbia, Vancouver, British Columbia, CanadaBackground Fibrotic interstitial lung disease (ILD) is frequently associated with abnormal oxygenation; however, little is known about the accuracy of oxygen saturation by pulse oximetry (SpO2) compared with arterial blood gas (ABG) saturation (SaO2), the factors that influence the partial pressure of carbon dioxide (PaCO2) and the impact of PaCO2 on outcomes in patients with fibrotic ILD.Study design and methods Patients with fibrotic ILD enrolled in a large prospective registry with a room air ABG were included. Prespecified analyses included testing the correlation between SaO2 and SpO2, the difference between SaO2 and SpO2, the association of baseline characteristics with both the difference between SaO2 and SpO2 and the PaCO2, the association of baseline characteristics with acid-base category, and the association of PaCO2 and acid-base category with time to death or transplant.Results A total of 532 patients with fibrotic ILD were included. Mean resting SaO2 was 92±4% and SpO2 was 95±3%. Mean PaCO2 was 38±6 mmHg, with 135 patients having PaCO2 <35 mmHg and 62 having PaCO2 >45 mmHg. Correlation between SaO2 and SpO2 was mild to moderate (r=0.39), with SpO2 on average 3.0% higher than SaO2. No baseline characteristics were associated with the difference in SaO2 and SpO2. Variables associated with either elevated or abnormal (elevated or low) PaCO2 included higher smoking pack-years and lower baseline forced vital capacity (FVC). Lower baseline lung function was associated with an increased risk of chronic respiratory acidosis. PaCO2 and acid-base status were not associated with time to death or transplant.Interpretation SaO2 and SpO2 are weakly-to-moderately correlated in fibrotic ILD, with limited ability to accurately predict this difference. Abnormal PaCO2 was associated with baseline FVC but was not associated with outcomes.https://bmjopenrespres.bmj.com/content/11/1/e002250.full |
spellingShingle | Deborah Assayag Julie Morisset Jolene H Fisher Hélène Manganas Christopher J Ryerson Martin Kolb Kerri Johannson Mira A Donaldson Kathryn Donohoe Celine Durand Stacey D Lok Veronica Marcoux Bohyung Min Daniel-Costin Marinescu Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease BMJ Open Respiratory Research |
title | Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease |
title_full | Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease |
title_fullStr | Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease |
title_full_unstemmed | Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease |
title_short | Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease |
title_sort | characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease |
url | https://bmjopenrespres.bmj.com/content/11/1/e002250.full |
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