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

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: A R Knebel, E Bentz, P Barnes
• Journal: Nursing research (Nurs Res) 2000 Nov-Dec Vol. 49 Issue 6 Pg. 333-8 ISSN: 0029-6562 [Print] United States
• PMID: 11093698 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)

Topics

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