COPD patients with severe diffusion defect in carbon monoxide diffusing capacity predict a better outcome for pulmonary rehabilitation

• Published in: Revista portuguesa de pneumologia (English ed.) Vol. 22; no. 6; pp. 323 - 330
• Main Authors: Sahin, H, Naz, I, Varol, Y, Aksel, N, Tuksavul, F, Ozsoz, A
• Format: Journal Article
• Language: English
• Published: Spain Elsevier 01.11.2016
• Subjects: Aged; Carbon Monoxide - physiology; Female; Humans; Internal Medicine; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Pulmonary Diffusing Capacity; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - rehabilitation; Pulmonary/Respiratory; Respiratory Function Tests; Severity of Illness Index; Treatment Outcome; Pulmonary function tests; Dyspnea; DLCO; 6-Minute walk test; Pulmonary rehabilitation; Quality of life
• ISSN: 2173-5115; 2173-5115
• DOI: 10.1016/j.rppnen.2016.03.003

AbstractPurposeThe aim of this study was to compare the effects of pulmonary rehabilitation (PR) on six-minute walk test (6mWT) between chronic obstructive pulmonary disease (COPD) patients with moderate or severe carbon monoxide diffusion defects. We also evaluated dyspnea sensation, pulmonary functions, blood gases analysis, quality of life parameters and psychological symptoms in both groups before and after pulmonary rehabilitation.MethodsPatients with COPD underwent a comprehensive 8-week out-patient PR program participated in this study. Patients grouped according to diffusion capacity as moderate or severe. Outcome measures were exercise capacity (6mWT), dyspnea sensation, pulmonary function tests, blood gases analysis, quality of life (QoL) and psychological symptoms.ResultsA total of 68 patients enrolled in the study. Thirty-two (47%) of them had moderate diffusion defect [T lCO; 52 (47–61) mmol/kPa] and 36 (53%) of them had severe diffusion defect [T lCO; 29 (22–34) mmol/kPa]. At the end of the program, PaO 2 ( p= 0.001), Modified Medical Research Council dyspnea scale ( p= 0.001), 6mWT ( p< 0.001) and quality of life parameters improved significantly in both groups ( p< 0.05). Also the improvement in D lCO ( p= 0.04) value and FEV 1% ( p= 0.01) reached a statistically significant level in patients with severe diffusion defect. When comparing changes between groups, dyspnea reduced significantly in patients with severe diffusion defect ( p= 0.04). ConclusionPulmonary rehabilitation improves oxygenation, severity of dyspnea, exercise capacity and quality of life independent of level of carbon monoxide diffusion capacity in patents with COPD. Furthermore pulmonary rehabilitation may improve D lCO values in COPD patients with severe diffusion defect.