Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1995 May;50(5):539–542. doi: 10.1136/thx.50.5.539

Nocturnal oxygen desaturation and spirometric parameters in adults with cystic fibrosis.

M N Pond 1, S P Conway 1
PMCID: PMC1021225  PMID: 7597668

Abstract

BACKGROUND--Correction of nocturnal hypoxaemia in patients with cystic fibrosis may delay the development of pulmonary hypertension. Descriptive statistics used for nocturnal arterial oxygen saturation (SpO2) lack uniformity. The relationship between SpO2 and spirometric parameters has not previously been explored in a large number of exacerbations in adult patients with cystic fibrosis. METHODS--Over a 21 month period overnight SpO2, forced expiratory volume in one second (FEV1), and forced vital capacity (FVC) were recorded on admission and discharge in 120 treatments of pulmonary exacerbations in 47 patients with cystic fibrosis who did not receive supplemental oxygen during recording. Nocturnal SpO2 was related to spirometric parameters for the whole group and individually in 11 patients, each of whom had at least five treatments. RESULTS--There was a close linear relationship between the percentage of the recording spent with SpO2 < 90% and mean overnight SpO2. Mean SpO2 correlated moderately with percentage predicted FEV1(%FEV1), r = 0.6, and poorly with percentage predicted FVC (%FVC), r = 0.34. The relationship between mean SpO2 and % FEV1 was non-linear at mean SpO2 < 89%, but approximated to linearity above this value. After exclusion of treatments with mean SpO2 < 89% the regression relationship between mean SpO2 and %FEV1 was the same on admission and discharge. Individual correlation coefficients of mean SpO2 versus % FEV1 in the 11 patients with repeated treatments ranged from 0.57 to 0.77. The slopes of the regression lines did not differ, with a pooled slope of 0.116, but the intercepts varied widely. CONCLUSIONS--In patients with cystic fibrosis mean overnight SpO2 can be substituted for percentage of recording < 90%. The relationship between mean SpO2 and percentage predicted FEV1 is non-linear at low values of SpO2 and is not influenced by treatment of pulmonary exacerbations. Patients with cystic fibrosis desaturate at a uniform rate compared with percentage predicted FEV1, but the value of FEV1 at which desaturation first occurs varies between patients. The spirometric values do not accurately predict nocturnal desaturation in a cystic fibrosis population, but FEV1 is a useful guide in individual patients with moderate desaturation.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agnew H. W., Jr, Webb W. B., Williams R. L. The first night effect: an EEG study of sleep. Psychophysiology. 1966 Jan;2(3):263–266. doi: 10.1111/j.1469-8986.1966.tb02650.x. [DOI] [PubMed] [Google Scholar]
  2. Braggion C., Pradal U., Mastella G. Hemoglobin desaturation during sleep and daytime in patients with cystic fibrosis and severe airway obstruction. Acta Paediatr. 1992 Dec;81(12):1002–1006. doi: 10.1111/j.1651-2227.1992.tb12163.x. [DOI] [PubMed] [Google Scholar]
  3. Coffey M. J., FitzGerald M. X., McNicholas W. T. Comparison of oxygen desaturation during sleep and exercise in patients with cystic fibrosis. Chest. 1991 Sep;100(3):659–662. doi: 10.1378/chest.100.3.659. [DOI] [PubMed] [Google Scholar]
  4. Davidson A., Bossuyt A., Dab I. Acute effects of oxygen, nifedipine, and diltiazem in patients with cystic fibrosis and mild pulmonary hypertension. Pediatr Pulmonol. 1989;6(1):53–59. doi: 10.1002/ppul.1950060113. [DOI] [PubMed] [Google Scholar]
  5. Francis P. W., Muller N. L., Gurwitz D., Milligan D. W., Levison H., Bryan A. C. Hemoglobin desaturation: its occurrence during sleep in patients with cystic fibrosis. Am J Dis Child. 1980 Aug;134(8):734–740. doi: 10.1001/archpedi.1980.02130200004002. [DOI] [PubMed] [Google Scholar]
  6. GOLDRING R. M., FISHMAN A. P., TURINO G. M., COHEN H. I., DENNING C. R., ANDERSEN D. H. PULMONARY HYPERTENSION AND COR PULMONALE IN CYSTIC FIBROSIS OF THE PANCREAS. J Pediatr. 1964 Oct;65:501–524. doi: 10.1016/s0022-3476(64)80286-9. [DOI] [PubMed] [Google Scholar]
  7. Gaines H., Albert J., von Sydow M., Sönnerborg A., Chiodi F., Ehrnst A., Strannegård O., Asjö B. HIV antigenaemia and virus isolation from plasma during primary HIV infection. Lancet. 1987 Jun 6;1(8545):1317–1318. doi: 10.1016/s0140-6736(87)90570-8. [DOI] [PubMed] [Google Scholar]
  8. Montgomery M., Wiebicke W., Bibi H., Pagtakhan R. D., Pasterkamp H. Home measurement of oxygen saturation during sleep in patients with cystic fibrosis. Pediatr Pulmonol. 1989;7(1):29–34. doi: 10.1002/ppul.1950070108. [DOI] [PubMed] [Google Scholar]
  9. Muller N. L., Francis P. W., Gurwitz D., Levison H., Bryan A. C. Mechanism of hemoglobin desaturation during rapid-eye-movement sleep in normal subjects and in patients with cystic fibrosis. Am Rev Respir Dis. 1980 Mar;121(3):463–469. doi: 10.1164/arrd.1980.121.3.463. [DOI] [PubMed] [Google Scholar]
  10. Smith D. L., Freeman W., Cayton R. M., Stableforth D. E. Nocturnal hypoxaemia in cystic fibrosis: relationship to pulmonary function tests. Respir Med. 1994 Aug;88(7):537–539. doi: 10.1016/s0954-6111(05)80338-5. [DOI] [PubMed] [Google Scholar]
  11. Stokes D. C., McBride J. T., Wall M. A., Erba G., Strieder D. J. Sleep hypoxemia in young adults with cystic fibrosis. Am J Dis Child. 1980 Aug;134(8):741–743. doi: 10.1001/archpedi.1980.02130200011004. [DOI] [PubMed] [Google Scholar]
  12. Versteegh F. G., Bogaard J. M., Raatgever J. W., Stam H., Neijens H. J., Kerrebijn K. F. Relationship between airway obstruction, desaturation during exercise and nocturnal hypoxaemia in cystic fibrosis patients. Eur Respir J. 1990 Jan;3(1):68–73. [PubMed] [Google Scholar]
  13. Versteegh F. G., Neijens H. J., Bogaard J. M., Stam H., Robijn R. J., Kerrebijn K. F. Relationship between pulmonary function, O2 saturation during sleep and exercise, and exercise responses in children with cystic fibrosis. Adv Cardiol. 1986;35:151–155. doi: 10.1159/000413448. [DOI] [PubMed] [Google Scholar]
  14. Warley A. R., Mitchell J. H., Stradling J. R. Evaluation of the Ohmeda 3700 pulse oximeter. Thorax. 1987 Nov;42(11):892–896. doi: 10.1136/thx.42.11.892. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES