| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
* From the Pulmonary Research Laboratory, University of British Columbia, Vancouver, BC, Canada.
Correspondence to: Pearce G. Wilcox, MD, Department of Medicine, Pulmonary Research Laboratory, McDonald Research Wing, Room 292, 1081 Burrard St, St. Paul’s Hospital, Vancouver, British Columbia, V6Z 1Y6, Canada.
Background: The purpose of this study was to determine how common sleep-related desaturation with preserved awake resting pulse oximetric saturation (SpO2) was in a large cohort of adult cystic fibrosis (CF) patients with variable degrees of pulmonary disease. We then determined whether nocturnal desaturation could reliably be predicted from standard clinical and exercise parameters.
Methods: Seventy CF patients participated in the study
(mean [SD] age, 27.3 [8.7] years; women, 54%; percent predicted
FEV1 [%predFEV1], 55.7% [23.9%]).
Nocturnal, resting, and exercise SpO2 were
measured. Nocturnal oximetry was measured in the patient’s home.
Maximal oxygen capacity (
O2max)
was determined from a graded exercise test on a stationary bicycle
ergometer. The Shwachman-Kulczycki (S-K) illness severity score was
calculated incorporating categories of functional capacity, physical
examination, nutrition, and chest radiograph.
Results:
Multivariate analysis reported significant differences (p < 0.0001)
between pulmonary disease severity and overall distribution of
nocturnal SpO2, with the main difference being
for patients with severe pulmonary disease (%predFEV1 of
< 50%) compared to patients with mild or moderate disease in the
SpO2 intervals of 100 to 96% (p < 0.0001)
and 90 to 86% (p = 0.0001). Pulmonary function, S-K clinical
scores, O2max, and resting and maximal
SpO2 correlated significantly (p < 0.05)
with nocturnal SpO2 levels. Stepwise
discriminant analysis identified %predFEV1 (or S-K scores)
and resting SpO2 as the parameters that could
best discriminate patients not likely to experience nocturnal
desaturation. Specifically, our equation could predict 91% of cases
less likely to nocturnally desaturate, but could only modestly predict
those more likely to desaturate (ie, 26% of
cases).
Conclusions: Spirometric parameters and measurements of awake resting oxygenation are of limited utility in predicting nocturnal desaturation. Nocturnal oximetry should be considered in patients with moderate to severe lung disease even with preserved awake resting SpO2.
Key Words: cystic fibrosis • exercise desaturation • nocturnal hypoxemia
This article has been cited by other articles:
|
|
 |
|
  D S Urquhart, H Montgomery, and A Jaffe Assessment of hypoxia in children with cystic fibrosis Arch. Dis. Child., November 1, 2005; 90(11): 1138 - 1143. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Frangolias, J. Ruan, P. J. Wilcox, A. G. F. Davidson, L. T. K. Wong, Y. Berthiaume, R. Hennessey, A. Freitag, L. Pedder, M. Corey, et al. {alpha}1-Antitrypsin Deficiency Alleles in Cystic Fibrosis Lung Disease Am. J. Respir. Cell Mol. Biol., September 1, 2003; 29(3): 390 - 396. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Frangolias, C. L. Holloway, S. Vedal, and P. G. Wilcox Role of Exercise and Lung Function in Predicting Work Status in Cystic Fibrosis Am. J. Respir. Crit. Care Med., January 15, 2003; 167(2): 150 - 157. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Milross, A. J. Piper, M. Norman, G. N. Willson, R. R. Grunstein, C. E. Sullivan, and P. T. P. Bye Predicting Sleep-Disordered Breathing in Patients With Cystic Fibrosis Chest, October 1, 2001; 120(4): 1239 - 1245. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
