Clinical Observation Of The Chronic Obstructive Pulmonary Disease Patients With Transcutaneous Carbon Dioxide Pressure, Transcutaneous Oxygen Pressure And Oxygen Saturation Change At Night

Objective: By studying the chronic obstructive pulmonary disease(COPD) in patients with transcutaneous carbon dioxide pressure (TcPCO2),transcutaneous oxygen pressure (TcPO2) and oxygen saturation (SaO2) changeat night, we explored TcPO2, TcPCO2and SaO2change of patients with theday resting oxygen saturation (SaO2)≥88%in different periods, the varyingdegrees of lung function and whether having oxygen at night, in order to givegreat importance for the clinical nocturnal hypoxemia with or without carbondioxide retention in patients with COPD, it can provide the scientific basis forgiving timely and effective treatment, preventing complications, improvingoutcomes and quality of life.Methods: Selecting the day resting SaO2≥88%patients which haveconfirmed COPD in He bei General Hospital Department of RespiratoryMedicine outpatient and inpatient from February2011to October2012,55cases, the stable COPD group30cases, the acute exacerbation of COPD group（AECOPD）25cases. the normal control group20cases, which are Healthyin the He bei General Hospital Medical Center. All patients were recorded age,sex, disease duration, and can not be drinking and taking sleeping pills within24h before the check. Depending on the degree of lung function, stable COPDpatients were divided into three groups, GOLD1, GOLD2and GOLD3. Thepatients with inhale the indoor air carried on percutaneous non-invasive bloodgas and oxygen saturation monitoring8h all night, indicators included TcPO2,TcPCO2, lowest oxygen saturation (LSaO2), the average oxygen saturation(MSaO2), oxygen saturation less than90%of the time the percentage of thetotal monitoring time (SLT90%). The patients with acute exacerbation of COPD repeated percutaneous non-invasive blood gas monitoring which wereinhaling1.5L/min oxygen second night. All datum were showed as±SD,which had normality test and homogeneity of variance test, Comparisionsbetween two groups were performed by t-test. Comparisions among groupswere performed by ANOVA. Between groups were compared with SNK-q.Analysis of all datum was performed by SPSS version13.0(SPSS, Chicago,USA). A p value<0.05was considered statistically significant.Results: The general situation:30cases with stable COPD, age79.1±7.96years, disease duration15.10±6.91years,25patients with COPDacute exacerbation, age78.12±7.92years, disease duration14.72±7.28years,20cases of normal control group,age74.55±7.29years, without chronicobstructive pulmonary disease, The sex, age had no significant differenceamong the three groups (P>0.05). The disease duration had no significantdifference between stable COPD group and AECOPD group (P>0.05). TheHTcPO2, LTcPO2and MTcPO2in Stable COPD group and AECOPD groupwere lower than that in the normal control group, the difference wasstatistically significant (P<0.05), The HTcPO2, LTcPO2and MTcPO2inAECOPD group than that in stable COPD group decreased more significantly(P<0.05). The HTcPCO2, LTcPCO2and MTcPCO2in Stable COPD group andAECOPD group were higher than that in the normal control group, thedifference was statistically significant (P<0.05). The LSaO2and MSaO2inStable COPD group and AECOPD group were significantly lower than that inthe normal control, while SLT90%was significantly higher than that in thenormal control group, the differences were statistically significant (P<0.05).Depending on the degree of lung function, stable COPD patients were dividedinto three groups, GOLD1, GOLD2and GOLD3, The Transcutaneous oxygenpressure each indicators and percutaneous carbon dioxide partial pressure eachindicators among three groups were not statistically significant differences(P>0.05). The patients with acute exacerbation of COPD were given thenighttime low flow oxygen (1.5L/min), the HTcPO2, LTcPO2and MTcPO2more increased than that which were not given the nighttime low flow oxygen,the difference was statistically significant (P<0.05), while theHTcPCO2, LTcPCO2and MTcPCO2slightly increased, but the difference wasnot statistically significant (P>0.05).Conclusions:(1)The COPD patients with daytime resting oxygensaturation (SaO2)≥88%can occur hypoxemia with or without carbon dioxideretention, The patients with AECOPD more occurred than patients with stableCOPD;(2)The AECOPD patients with daytime resting oxygen saturation(SaO2)≥88%should be given with nocturnal intermittent low-flow oxygeninhalation therapy;(3)Transcutaneous noninvasive blood gas monitoring andoxygen saturation monitoring in COPD patients were joint clinical applicationto provide a more comprehensive theoretical basis for diagnosis nocturnalhypoxemia with or without carbon dioxide retention and guidance oxygeninhalation.