Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease.

Autor:	Donaldson MA; Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada., Donohoe K; College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA., Assayag D; Department of Medicine, McGill University, Montreal, Québec, Canada., Durand C; Département de Médecine, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Québec, Canada., Fisher JH; Department of Medicine, University of Toronto, Toronto, Ontario, Canada., Johannson K; Department of Medicine, University of Calgary, Calgary, Alberta, Canada., Kolb M; Department of Medicine, McMaster University, Hamilton, Ontario, Canada., Lok SD; Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada., Manganas H; Département de Médecine, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Québec, Canada., Marcoux V; Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada., Min B; Department of Medicine, University of Calgary, Calgary, Alberta, Canada., Morisset J; Département de Médecine, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Québec, Canada., Marinescu DC; Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.; Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada., Ryerson CJ; Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada chris.ryerson@hli.ubc.ca.; Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open respiratory research [BMJ Open Respir Res] 2024 Mar 13; Vol. 11 (1). Date of Electronic Publication: 2024 Mar 13.
DOI:	10.1136/bmjresp-2023-002250
Abstrakt:	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 (SpO 2 ) compared with arterial blood gas (ABG) saturation (SaO 2 ), the factors that influence the partial pressure of carbon dioxide (PaCO 2 ) and the impact of PaCO 2 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 SaO 2 and SpO 2 , the difference between SaO 2 and SpO 2 , the association of baseline characteristics with both the difference between SaO 2 and SpO 2 and the PaCO 2 , the association of baseline characteristics with acid-base category, and the association of PaCO 2 and acid-base category with time to death or transplant. Results: A total of 532 patients with fibrotic ILD were included. Mean resting SaO 2 was 92±4% and SpO 2 was 95±3%. Mean PaCO 2 was 38±6 mmHg, with 135 patients having PaCO 2 <35 mmHg and 62 having PaCO 2 >45 mmHg. Correlation between SaO 2 and SpO 2 was mild to moderate (r=0.39), with SpO 2 on average 3.0% higher than SaO 2 . No baseline characteristics were associated with the difference in SaO 2 and SpO 2 . Variables associated with either elevated or abnormal (elevated or low) PaCO 2 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. PaCO 2 and acid-base status were not associated with time to death or transplant. Interpretation: SaO 2 and SpO 2 are weakly-to-moderately correlated in fibrotic ILD, with limited ability to accurately predict this difference. Abnormal PaCO 2 was associated with baseline FVC but was not associated with outcomes. Competing Interests: Competing interests: MAD reports no conflicts of interest relevant to this manuscript. KD reports no conflicts of interest relevant to this manuscript. DA reports grants and personal fees from Boehringer Ingelheim, grants from Canadian Institute for Health Research and from Fonds de Recherche du Quebec en Santé. CD reports no conflicts of interest relevant to this manuscript. JHF reports personal fees from AstraZeneca and Boehringer Ingelheim. KJ reports grants from Boehringer Ingelheim, Pulmonary Fibrosis Society of Calgary, University of Calgary School of Medicine; personal fees from Boehringer Ingelheim, Roche, Three Lakes Foundation, Pliant Therapeutics, Theravance, Blade Therapeutics. MK reports grants from Canadian Institute for Health Research, Roche, Boehringer Ingelheim, Pieris, Prometic; personal fees from Boehringer Ingelheim, Roche, European Respiratory Journal, Belerophon, United Therapeutics, Nitto Denko, MitoImmune, Pieris, AbbVie, DevPro Biopharma, Horizon, Algernon, CSL Behring. SDL reports consulting/personal fees and moderator honoraria from Boehringer-Ingelheim, honoraria from Hoffman-La Roche Ltd, grants from AstraZeneca and the University of Saskatchewan. HM reports grants from Boehringer Ingelheim and Gilead. VM reports grants from Boehringer Ingelheim, AstraZeneca, and Roche; personal fees from Boehringer Ingelheim and Roche. BM reports no conflicts of interest relevant to this manuscript. JM reports personal fees from Boehringer Ingelheim and Roche. D-CM reports personal fees from Boehringer Ingelheim. CJR reports grants from Boehringer Ingelheim; personal fees from AstraZeneca, Boehringer Ingelheim, Roche, Pliant Therapeutics, Cipla, Veracyte. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu