Blood oxygen equilibration time after cessation of supplemental oxygen in chronic respiratory disease

Intern Med J. 2015 Jan;45(1):26-32. doi: 10.1111/imj.12589.

Abstract

Background: Measurement of the arterial partial pressure of oxygen (PaO2 ) while breathing air is an informative investigation in patients with hypoxaemia due to chronic respiratory disease, but there are a lack of published data on the time needed for blood oxygen levels to equilibrate after cessation of supplemental oxygen (O2 ) in such patients.

Aim: To determine the blood oxygen equilibration time after cessation of O2 and thereby provide guidance on best timing of baseline arterial blood gas analysis in this population.

Methods: Medically stable subjects with chronic respiratory disease were administered O2 at a constant concentration. Continuous pulse oximetry was recorded from before cessation of O2 to beyond the point of oxygen saturation (SpO2 ) equilibration. Data were fitted to an exponential decay model. Blood oxygen equilibration time was defined as the t90, the time taken for SpO2 to fall 90% of the difference between initial (on O2 ) and final (on air) values.

Results: Eighty-two (82) subjects with a mean age of 66 years were included. The largest diagnostic category was chronic obstructive pulmonary disease (37), followed by interstitial lung disease (15) and bronchiectasis (12). The median t90 was 6 min 18 s (interquartile range: 4 min 32 s-10 min 30 s). The 95th centile t90 value was 20 min.

Conclusion: In the majority of patients with chronic respiratory disease, a time delay of 20 min between cessation of supplemental O2 and PaO2 measurement allows confidence that the result is a true baseline value.

Keywords: arterial blood gas; chronic respiratory disease; hypoxaemia; oximetry; supplemental oxygen.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Gas Analysis
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods*
  • Oxygen / pharmacokinetics*
  • Oxygen Inhalation Therapy / methods*
  • Partial Pressure
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive / blood*
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Young Adult

Substances

  • Oxygen