• 作者：Diego A. Rodrí ; guez^a ; Lluis Jover^b ; Mitra B. Drakulovic^a ; Federico P. Gó ; mez^a ; Josep Roca^a ; Joan Albert Barberà ; ^a ; Peter D. Wagner^c ; Roberto Rodrí ; guez-Roisin^a ; ^{rororo@clinic.ub.es}
• 关键词：Limitació ; n al flujo aé ; reo ; Gasometrí ; a arterial ; Insuficiencia respiratoria cró ; nica ; Intercambio pulmonar de gases
• 刊名：Archivos de Bronconeumolog铆a
• 出版年：2011
• 期刊代码：pca65_03002896
• 类别：med
• 出版时间：July 2011
• 卷：47
• 期：7
• 页码：325-329
• 文件大小：299 K

Introduction

To diagnose and assess chronic respiratory failure in stable chronic obstructive pulmonary disease (COPD) the measurement of arterial blood gases (ABG) is required. It has been suggested that ABG be determined for this purpose when FEV1 ranges between 50%and 30%predicted, but these thresholds are not evidence-based.

Objective

To identify the post-bronchodilator (BD) FEV₁ and arterial oxygen saturation (SaO₂) values that provide the best sensitivity, specificity, and likelihood ratio (LR) for the diagnosis of hypoxaemic and/or hypercapnic chronic respiratory failure in stable COPD.

Methods

A total of 150聽patients were included (39聽with PaO₂ <聽60聽mmHg [8聽kPa], 14 of them with a PaCO₂ 鈮ヂ?0聽mmHg [6.7聽kPa]). The best post-BD FEV₁ and SaO₂ cut-off points to predict chronic respiratory failure were selected using the PC and the Receiver Operating Characteristics (ROC) curves.

Results

A post-BD FEV₁ equal to 36%and an SaO₂ of 90%were the best predictive values for hypoxaemic respiratory failure and a post-BD FEV₁ equal to 33%for the hypercapnic variant. An FEV₁ 鈮ヂ?5%ruled out hypoxaemic respiratory failure.

Conclusion

A post-BD FEV₁ of 36%is the best cut-off point to adequately predict both hypoxaemic and hypercapnic respiratory failure in the patient with stable COPD. For its part, an SaO₂ of 90%is the best value for isolated hypoxaemic failure. These values could be considered for future clinical recommendations/guidelines for COPD.