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Validation of Noninvasive Assessment of Pulmonary Gas Exchange in Patients with Chronic Obstructive Pulmonary Disease during Initial Exposure to High Altitude.
Champigneulle, Benoit; Reinhard, Lukas; Mademilov, Maamed; Marillier, Mathieu; Ulrich, Tanja; Carta, Arcangelo F; Scheiwiller, Philipp; Shabykeeva, Saltanat B; Sheraliev, Ulan U; Abdraeva, Ainura K; Magdieva, Kamila M; Mirzalieva, Gulzada; Taalaibekova, Aijan T; Ozonova, Aigul K; Erkinbaeva, Aidai O; Shakiev, Nurdin U; Azizbekov, Syimyk A; Ainslie, Philip N; Sooronbaev, Talant M; Ulrich, Silvia; Bloch, Konrad E; Verges, Samuel; Furian, Michael.
Afiliação
  • Champigneulle B; HP2 Laboratory, INSERM U1300, Grenoble Alpes University, CHU Grenoble Alpes, 38400 Grenoble, France.
  • Reinhard L; Department of Anesthesia and Critical Care, Grenoble Alpes University Hospital, 38043 Grenoble, France.
  • Mademilov M; Department of Pulmonology, University Hospital Zürich, 8091 Zurich, Switzerland.
  • Marillier M; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, 8091 Zurich, Switzerland.
  • Ulrich T; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Bishkek 720040, Kyrgyzstan.
  • Carta AF; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, 8091 Zurich, Switzerland.
  • Scheiwiller P; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Bishkek 720040, Kyrgyzstan.
  • Shabykeeva SB; Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek 720040, Kyrgyzstan.
  • Sheraliev UU; HP2 Laboratory, INSERM U1300, Grenoble Alpes University, CHU Grenoble Alpes, 38400 Grenoble, France.
  • Abdraeva AK; Department of Pulmonology, University Hospital Zürich, 8091 Zurich, Switzerland.
  • Magdieva KM; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, 8091 Zurich, Switzerland.
  • Mirzalieva G; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Bishkek 720040, Kyrgyzstan.
  • Taalaibekova AT; Department of Pulmonology, University Hospital Zürich, 8091 Zurich, Switzerland.
  • Ozonova AK; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, 8091 Zurich, Switzerland.
  • Erkinbaeva AO; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Bishkek 720040, Kyrgyzstan.
  • Shakiev NU; Department of Pulmonology, University Hospital Zürich, 8091 Zurich, Switzerland.
  • Azizbekov SA; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, 8091 Zurich, Switzerland.
  • Ainslie PN; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Bishkek 720040, Kyrgyzstan.
  • Sooronbaev TM; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, 8091 Zurich, Switzerland.
  • Ulrich S; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Bishkek 720040, Kyrgyzstan.
  • Bloch KE; Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek 720040, Kyrgyzstan.
  • Verges S; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, 8091 Zurich, Switzerland.
  • Furian M; Swiss-Kyrgyz High-Altitude Medicine and Research Initiative, Bishkek 720040, Kyrgyzstan.
J Clin Med ; 12(3)2023 Jan 19.
Article em En | MEDLINE | ID: mdl-36769447
Investigation of pulmonary gas exchange efficacy usually requires arterial blood gas analysis (aBGA) to determine arterial partial pressure of oxygen (mPaO2) and compute the Riley alveolar-to-arterial oxygen difference (A-aDO2); that is a demanding and invasive procedure. A noninvasive approach (AGM100), allowing the calculation of PaO2 (cPaO2) derived from pulse oximetry (SpO2), has been developed, but this has not been validated in a large cohort of chronic obstructive pulmonary disease (COPD) patients. Our aim was to conduct a validation study of the AG100 in hypoxemic moderate-to-severe COPD. Concurrent measurements of cPaO2 (AGM100) and mPaO2 (EPOC, portable aBGA device) were performed in 131 moderate-to-severe COPD patients (mean ±SD FEV1: 60 ± 10% of predicted value) and low-altitude residents, becoming hypoxemic (i.e., SpO2 < 94%) during a short stay at 3100 m (Too-Ashu, Kyrgyzstan). Agreements between cPaO2 (AGM100) and mPaO2 (EPOC) and between the O2-deficit (calculated as the difference between end-tidal pressure of O2 and cPaO2 by the AGM100) and Riley A-aDO2 were assessed. Mean bias (±SD) between cPaO2 and mPaO2 was 2.0 ± 4.6 mmHg (95% Confidence Interval (CI): 1.2 to 2.8 mmHg) with 95% limits of agreement (LoA): -7.1 to 11.1 mmHg. In multivariable analysis, larger body mass index (p = 0.046), an increase in SpO2 (p < 0.001), and an increase in PaCO2-PETCO2 difference (p < 0.001) were associated with imprecision (i.e., the discrepancy between cPaO2 and mPaO2). The positive predictive value of cPaO2 to detect severe hypoxemia (i.e., PaO2 ≤ 55 mmHg) was 0.94 (95% CI: 0.87 to 0.98) with a positive likelihood ratio of 3.77 (95% CI: 1.71 to 8.33). The mean bias between O2-deficit and A-aDO2 was 6.2 ± 5.5 mmHg (95% CI: 5.3 to 7.2 mmHg; 95%LoA: -4.5 to 17.0 mmHg). AGM100 provided an accurate estimate of PaO2 in hypoxemic patients with COPD, but the precision for individual values was modest. This device is promising for noninvasive assessment of pulmonary gas exchange efficacy in COPD patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Clin Med Ano de publicação: 2023 Tipo de documento: Article País de afiliação: França País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Clin Med Ano de publicação: 2023 Tipo de documento: Article País de afiliação: França País de publicação: Suíça