Assessment of Partial Pressure of Carbon Dioxide during Incremental Exercise Test, in Patients with Chronic Obstructive Pulmonary Disease
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Abstract
Purpose: Respiratory pump failure in COPD patients can lead to CO2 retention during exercise, but little is known about the factors determining CO2-levels during exercise in COPD patients.
The aim of this study is to investigate the pattern of TcPCO2 in COPD patients during exercise and factors driving this CO2 response.
Patients and methods: 24 COPD patients (age 66(8) y, FEV1 43(18) %pred, TcPCO2 at rest 37(4) mmHg, oxygen users 6/24) performed lung function and cardiopulmonary exercise test (CPET). During CPET TcPCO2 was measured continuously and in O2 users the CPET was performed with supplemental oxygen.
Results: At baseline, 16 patients were normocapnic (TcPCO2 35-45 mmHg) and 8 hypocapnic (TcPCO2<35 mmHg). At the end of the CPET, 9 patients were normocapnic, 2 showed hypocapnia and 10 were hypercapnic. CO2-retention (∆TcPCO2 >4mmHg) was observed in 18 patients.
∆TcPCO2 correlated significantly with VeMax (r=-.64; p=.004), FEV1 %predicted (r = -.53; p = .008), RV %predicted (r = .54; p = .007), RV/TLC (r = .56; p = .005), sRAW (r =.61; p = .005), sGAW (r = -.60; p = .002), and maximal TcPCO2 (r=.63; p<.001), but did not correlate with baseline TcPCO2 (r = -.08; p = .728). Furthermore, baseline TcPCO2 correlated with the maximal TcPCO2 (r = 0.67; p < .001).
Conclusion: The CO2-response of COPD-patients during CPET is heterogeneous with 10/24 developing hypercapnia. This study revealed that the lung mechanics are the most important factor correlating with CO2 retention during exercise while ∆TcPCO2 was not associated with baseline TcPCO2.
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