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Canadian Respiratory Journal
Volume 18, Issue 6, Pages 333-337
http://dx.doi.org/10.1155/2011/242636
Original Article

Oxygen Desaturation During a 6 Min Walk Test is a Sign of Nocturnal Hypoxemia

Adrienne S Scott,1 Marcel A Baltzan,1 Ryan Chan,2 and Norman Wolkove1

1Reasearch Department, Mount Sinai Hospital Center, Canada
2Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada

Copyright © 2011 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND/OBJECTIVES: Patients with chronic obstructive pulmonary disease (COPD) may experience sleep disordered breathing with nocturnal desaturation. An exploratory study was performed to determine whether any commonly measured clinical parameters were useful in predicting nocturnal desaturation in patients with COPD. A validation study was subsequently performed to confirm the utility of the parameter identified in the exploratory study as most useful in this regard.

METHODS: A total of 103 (exploratory cohort) and 200 (validation cohort) consecutive patients with COPD admitted for pulmonary rehabilitation were evaluated. Standard outcome measures including nocturnal oximetry and the 6 min walk test (6MWT) on room air with continuous pulse oximetry were assessed. Patients with sleep apnea or those undergoing long-term oxygen therapy were excluded.

RESULTS: In the exploratory study, the mean (± SD) patient age was 70±9.9 years, with forced expiratory volume in 1 s of 0.76±0.34 L, which was 36±16% of predicted. Body mass index, arterial oxygen tension, oxygen saturation by pulse oximetry at rest and during the 6MWT all demonstrated significant correlations with percentage of time spent with a saturation <90%. When the lowest pulse oximetry during the 6MWT was ≤88%, 10 of 21 patients demonstrated a saturation <90% for at least 30% of sleep time. This measure yielded a positive likelihood ratio of 3.77 (95% CI 1.87 to 7.62) compared with those who did not reach this threshold value. The validation study confirmed similar detection characteristics.

CONCLUSIONS: Results from the present study suggest that monitoring oxygen saturation changes during a 6MWT is useful in helping to identify COPD patients who may experience significant nocturnal desaturation.