Dyspnea management in alpha-1 antitrypsin deficiency: effect of oxygen administration.

Methods Development
Therapeutic Approaches
Other

Abstract

BACKGROUND: A deficiency of alpha-1 antitrypsin (AAT) can lead to pulmonary disease in middle-aged adults in whom dyspnea management can be a significant issue. OBJECTIVE: The research addressed whether short-term oxygen (O2) administration during activities might decrease dyspnea and improve exercise performance in nonhypoxemic patients with emphysema caused by a deficiency of alpha-1 antitrypsin. METHOD: This was a double-blind, randomized crossover study of 31 subjects with a deficiency of AAT (mean + SD, age = 47 +/- 7), moderate emphysema and a resting PaO2 > 70 mm Hg. Oxygen saturation (SpO2), 6-minute walk distance, and end of walk dyspnea were measured during three practice walks and during walks with nasal cannula administration of O2 (intervention) and compressed air (control). RESULTS: Repeated measures analysis of variance (ANOVA) showed significant differences across the walks for SpO (F= 18.9, p = 0.0001), 6-minute walk distance (F= 6.07, p = 0.004), and dyspnea (F= 4.44, p = 0.016). Using post hoc contrasts, SpO2 was the only variable that differed between 20, and compressed air (p < 0.0001). There was, however, an interaction effect of gender with O2 for dyspnea (F= 9.85, p = 0.004). Mean values showed that men did not benefit from O2 (p = 0.87). However, women experienced less dyspnea when receiving O2 as compared with compressed air (p = 0.0025), and although not statistically significant, the lower dyspnea with O2 corresponded with an increased walk distance of 79 feet. CONCLUSIONS: O2 administration may be useful for reducing dyspnea during exercise in selected populations.

Authors

Knebel, Ann; Bentz, E; Barnes, P;

Keywords

  • Adult
  • Aged
  • Analysis of Variance
  • Cross-Over Studies
  • Double-Blind Method
  • Dyspnea/ classification
  • Dyspnea/ etiology
  • Dyspnea/ therapy
  • Female
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Oximetry
  • Oxygen Inhalation Therapy
  • Pain Measurement
  • Walking
  • alpha 1-Antitrypsin Deficiency/ complications

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