Chest
Original ResearchCOPDMonitoring Breathing Rate at Home Allows Early Identification of COPD Exacerbations
Section snippets
Study Design and Ethics
This prospective cohort study was conducted in six tertiary referral hospitals in Spain, five in Madrid (Hospital La Paz-Instituto de Investigación La Paz, Hospital La Princesa, Hospital Puerta de Hierro, Hospital Gregorio Marañón, and Hospital Clínico San Carlos), and one in Palma de Mallorca (Hospital Universitari Son Espases). After the patient signed the informed consent, being aware of its nature and goals, respiratory frequency was monitored at home (see the “Study Design and Ethics”
Results
Between October 2009 and March 2010, 126 patients were recruited. Thirty-seven of them were excluded from analysis for different reasons: 12 because of technical problems with the monitor resulting in insufficient data for analysis and 25 because of poor compliance with oxygen therapy so that they did not have enough data to calculate both the baseline and random periods. Hence, a total of 89 patients were finally included in the analysis. Their mean age was 76.2 ± 6.5 years, 74% of them were
Discussion
This study explores a novel and potentially clinically relevant hypothesis: The increase in respiratory frequency that characterizes the episodes of ECOPD can be detected days before hospitalization. Our results confirm this hypothesis and open the possibility of exploring, in a larger and formally randomized clinical trial, the potential benefits of an early therapeutic intervention during this window of opportunity on relevant clinical outcomes, such as need for hospitalization, length of
Acknowledgments
Author contributions: Dr Yáñez confirms that the study objectives and procedures are honestly disclosed.
Dr Yañez: contributed to conception and design of the original idea, data analysis, and drafting of the manuscript.
Ms Guerrero: contributed to statistical support, data analysis, and drafting of the manuscript.
Dr Pérez de Alejo: contributed to data collection, conception and design of the original idea, data analysis, and drafting of the manuscript.
Dr Garcia-Rio: contributed to data
References (18)
- et al.
International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study
Lancet
(2007) Toward a consensus definition for COPD exacerbations
Chest
(2000)- et al.
COPD exacerbations: defining their cause and prevention
Lancet
(2007) - et al.
Measuring breathing pattern in patients with chronic obstructive pulmonary disease by electrical impedance tomography [in Spanish]
Arch Bronconeumol
(2009) - et al.
Accuracy of respiratory inductive plethysmography during wakefulness and sleep in patients with obstructive sleep apnea
Chest
(1992) - et al.
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary
Am J Respir Crit Care Med
(2001) - et al.
Oxygen therapy during exacerbations of chronic obstructive pulmonary disease
Eur Respir J
(1999) - et al.
A controlled trial of noninvasive ventilation for chronic obstructive pulmonary disease exacerbations
J Crit Care
(2009) - et al.
Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease
Am J Respir Crit Care Med
(2000)
Cited by (0)
Funding/Support: This study was supported by Air Products Sud Europa, Madrid, Spain.
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