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Chest. 2012 Dec;142(6):1524-1529. doi: 10.1378/chest.11-2728.

Monitoring breathing rate at home allows early identification of COPD exacerbations.

Author information

1
Fundación de Investigación Sanitaria Illes Balears (FISIB), Palma de Mallorca, Madrid. Electronic address: aina.yanez@caubet-cimera.es.
2
Fundación de Investigación Sanitaria Illes Balears (FISIB), Palma de Mallorca, Madrid.
3
Airproducts Sud Europa, Madrid.
4
Servicio de Neumología, Hospital Universitario La Paz, Instituto de Investigación La Paz (IdiPAZ), Madrid.
5
Servicio de Neumología, Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense, Madrid.
6
Hospital Universitario Puerta de Hierro, Majadahonda, Madrid.
7
Servei Pneumologia, Hospital Universitari Son Espases, Palma Mallorca.
8
Servicio de Neumología, Hospital de La Princesa, Madrid.
9
Servicio de Neumología, Hospital Gregorio Marañón, Madrid.
10
Ib-salut, Área de Salut de Menorca, Menorca.
11
Thorax Institute, Hospital Clínic, Institut d'Investigacions Biomediques Agustí Pi i Sunyer (IDIBAPS), Universitat Barcelona, CIBER Enfermedades Respiratorias (CIBERES), and Fundación de Investigación Sanitaria Illes Balears (FISIB) Mallorca, Spain.

Abstract

BACKGROUND:

Respiratory frequency increases during exacerbations of COPD (ECOPD). We hypothesized that this increase can be detected at home before ECOPD hospitalization.

METHODS:

To test this hypothesis, respiratory frequency was monitored at home daily for 3 months in 89 patients with COPD (FEV₁, 42.3% ± 14.0%; reference) who were receiving domiciliary oxygen therapy (9.6 ± 4.0 h/d).

RESULTS:

During follow-up, 30 patients (33.7%) required hospitalization because of ECOPD. In 21 of them (70%), mean respiratory frequency increased (vs baseline) during the 5 days that preceded it (from 15.2 ± 4.3/min to 19.1 ± 5.9/min, P < .05). This was not the case in patients without ECOPD (16.1 ± 4.8/min vs 15.9 ± 4.9/min). Receiver operating characteristic analysis showed that 24 h before hospitalization, a mean increase of 4.4/min (30% from baseline) provided the best combination of sensitivity (66%) and specificity (93%) (area under the curve [AUC] = 0.79, P < .05). Two days before hospitalization, a mean increase of 2.3/min (15% change from baseline) was associated with a sensitivity of 72% and a specificity of 77% (AUC = 0.76, P < .05).

CONCLUSIONS:

Respiratory frequency can be monitored daily at home in patients with COPD receiving domiciliary oxygen therapy. In these patients, breathing rate increases significantly days before they require hospitalization because of ECOPD. This may offer a window of opportunity for early intervention.

PMID:
22797131
DOI:
10.1378/chest.11-2728
[Indexed for MEDLINE]

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