J Korean Med Sci.  2011 Mar;26(3):372-378. 10.3346/jkms.2011.26.3.372.

Hypoxemia and Arrhythmia during Daily Activities and Six-minute Walk Test in Fibrotic Interstitial Lung Diseases

• Park JH
• Jegal Y
• Shim TS
• Lim CM
• Lee SD
• Koh Y
• Kim WS
• Kim WD
• Bois RD
• Do KH
• Kim DS

• KMID: 2157874
• DOI: http://doi.org/10.3346/jkms.2011.26.3.372

Abstract

We performed 24-hr monitoring of pulse oximetric saturation (SpO2) with ECG and six-minute walk test (6MWT) in 19 patients with fibrotic interstitial lung diseases (ILD) to investigate; 1) The frequency and severity of hypoxemia and dysrhythmia during daily activities and 6MWT, 2) safety of 6MWT, and 3) the parameters of 6MWT which can replace 24-hr continuous monitoring of SpO2 to predict hypoxemia during daily activities. All patients experienced waking hour hypoxemia, and eight of nineteen patients spent > 10% of waking hours in hypoxemic state. Most patients experienced frequent arrhythmia, mostly atrial premature contractions (APCs) and ventricular premature contractions (VPCs). There were significant correlation between the variables of 6MWT and hypoxemia during daily activities. All of the patients who desaturated below 80% before 300 meters spent more than 10% of waking hour in hypoxemia (P = 0.018). In contrast to waking hour hypoxemia, SpO2 did not drop significantly during sleep except in the patients whose daytime resting SpO2 was already low. In conclusion, patients with fibrotic ILD showed significant period of hypoxemia during daily activities and frequent VPCs and APCs. Six-minute walk test is a useful surrogate marker of waking hour hypoxemia and seems to be safe without continuous monitoring of SpO2.

Keyword

Arrhythmias, Cardiac; Anoxia; Lung Diseases, Interstitial; Six-Minute Walk Test

MeSH Terms

*Activities of Daily Living
Aged
Anoxia/*physiopathology
Arrhythmias, Cardiac/*physiopathology
Dyspnea/physiopathology
Electrocardiography, Ambulatory
Exercise Test
Exercise Tolerance
Female
Humans
Lung Diseases, Interstitial/*physiopathology
Male
Middle Aged
Motor Activity/*physiology
Oximetry
Respiratory Function Tests
Sleep
Walking

Figure

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  Fig. 1 The relationship of six-minute walk test and duration of waking hour hypoxemia. There was significant negative correlation between walk distance until 80% of SpO2 during six-minute walk test and the duration of hypoxemia during daily activities in patients with interstitial lung diseases.

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