Inagaki T, Yahaba M, Terada J, Kawata N, Asano Y, Murata A, Amata A, Tanabe N, Tatsumi K
Background: Long-term oxygen therapy, including ambulatory oxygen, has been widely used for patients with COPD having chronic respiratory failure. However, factors important for selecting suitable carriers of ambulatory oxygen, such as a cylinder cart or backpack, remain unclear for patients with moderate-to-severe COPD. Methods: Twelve patients with moderate-to-severe COPD (mean age, 69.6 ± 7.3 years) performed a six-minute walk test (6MWT) with a cylinder cart and backpack in random order. The parameters of 6MWT with each carrier, pulmonary function test results, and a questionnaire about the preference of each carrier after 6MWTs were analyzed. Results: The Δ distance (distance walked with a backpack - that waked with a cylinder cart) positively correlated with FEV1 (r=0.678, P=0.02) and lung diffusing capacity for carbon monoxide (DLCO) (r=0.606, P=0.048). Patients who could walk longer with a backpack were significantly higher in FEV1 (1.3 ± 0.8 vs. 0.8 ± 0.1 L, P=0.040) and DLCO (13.6 ± 2.1 vs. 8.2 ± 3.3 ml/min/mmHg, P=0.02) than those who walked longer with a cylinder cart. Additionally, patients who could walk longer with a backpack showed a lower maximum pulse rate and pulse rate after 6MWT than those who walked longer with a cylinder cart. Further, patients who preferred a backpack were significantly higher in percentage of predicted FVC (%FVC; 94.4 ± 17.2 vs. 65.5 ± 11.6% P=0.02) and lower in residual volume (2.7 ± 0.8 vs. 4.0 ± 0.6 L, P=0.042) than those who preferred a cylinder cart. Conclusions: FEV1, DLCO, and pulse rate during and/or after 6MWT can be important factors in the selection of proper ambulatory oxygen transport carriers for greater exercise capacity in patients with COPD having chronic respiratory failure.
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