Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias?

Benoit Wallaert; Lidwine Wemeau-Stervinou; Julia Salleron; Isabelle Tillie-Leblond; Thierry Perez

doi:10.1155/2012/657180

journal article Open Access Jan 01, 2012

Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias?

Benoit Wallaert

Lidwine Wemeau-Stervinou Julia Salleron Isabelle Tillie-Leblond Thierry Perez

Pulmonary Medicine Vol. 2012 pp. 1-7 · Wiley

View at Publisher Save 10.1155/2012/657180

Abstract

In patients with fibrotic idiopathic interstitial pneumonia (f-IIP), the diffusing capacity for carbon monoxide (DLCO) has been used to predict abnormal gas exchange in the lung. However, abnormal values for arterial blood gases during exercise are likely to be the most sensitive manifestations of lung disease. The aim of this study was to compare DLCO, resting PaO2, P(A-a)O2at cardiopulmonary exercise testing peak, and oxygen desaturation during a 6-min walk test (6MWT). Results were obtained in 121 patients with idiopathic pulmonary fibrosis (IPF,n=88) and fibrotic nonspecific interstitial pneumonias (NSIP,n=33). All but 3 patients (97.5%) had low DLCO values (<LLN) whereas only 66.6% had low KCO; 42 patients (65%) exhibited resting hypoxemia (<75 mmHg); 112 patients (92.5%) exhibited a high P[(A-a)O2], peak (>35 mmHg) and 100 (83%) demonstrated significant oxygen desaturation during 6MWT (>4%). Interestingly 27 patients had low DLCO and normal P(A-a)O2, peak and/or no desaturation during the 6MWT. The 3 patients with normal DLCO also had normal PaO2, normal P(A-a)O2, peak, and normal oxygen saturation during 6MWT. Our results demonstrate that in fibrotic IIP, DLCO better defines impairment of pulmonary gas exchange than resting PaO2, exercise P(A-a)O2, peak, or 6MWT SpO2.

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Details

Published: Jan 01, 2012
Vol/Issue: 2012
Pages: 1-7
License: View

Authors

B

Benoit Wallaert

Clinique des Maladies Respiratoires, Centre de Compétence des Maladies Pulmonaires Rares, Hopital Calmette, Lille 2 University Boulevard Leclercq, CHRU, 59037 Lille, France

L

Lidwine Wemeau-Stervinou

Clinique des Maladies Respiratoires, Centre de Compétence des Maladies Pulmonaires Rares, Hopital Calmette, Lille 2 University Boulevard Leclercq, CHRU, 59037 Lille, France

J

Julia Salleron

Unité de Biostatistiques, CHRU, 59037 Lille, France

I

Isabelle Tillie-Leblond

Clinique des Maladies Respiratoires, Centre de Compétence des Maladies Pulmonaires Rares, Hopital Calmette, Lille 2 University Boulevard Leclercq, CHRU, 59037 Lille, France

T

Thierry Perez

Clinique des Maladies Respiratoires, Centre de Compétence des Maladies Pulmonaires Rares, Hopital Calmette, Lille 2 University Boulevard Leclercq, CHRU, 59037 Lille, France; Service d'Explorations Fonctionnelles Respiratoires, Hopital Calmette, CHRU, 59037 Lille, France

Cite This Article

Benoit Wallaert, Lidwine Wemeau-Stervinou, Julia Salleron, et al. (2012). Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias?. Pulmonary Medicine, 2012, 1-7. https://doi.org/10.1155/2012/657180

Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias?

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