Portable Oxygen Therapy: Is the 6-Minute Walking Test Overestimating the Actual Oxygen Needs?

Abstract

The appropriate titration for the personalized oxygen needs of patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia is a determining factor in the success of long-term oxygen therapy. There are no standardized procedures to assist in determining the patient's needs during the physical activities of daily life. Despite that effort tests are a wide broad approach, further research concerning the development of protocols to titrate O-2 therapy is needed. The main objective of this study was to assess whether the level of oxygen titrated through the 6-minute walking test (6MWT) for patients with COPD and exertional hypoxemia is adequate to meet the patients' demand during their activities of daily living. Physiological and subjective variables were estimated for a study population during two walking tests: a 6MWT and a 20-minute walking circuit (20MWC), designed ad-hoc to reproduce daily physical activities more truthfully. The results indicate that in a significant proportion of patients, the 6MWT might not accurately predict their oxygen needs at a domiciliary environment. Therefore, the titration of the portable O-2 therapy could not be optimal in these cases, with the detrimental impact on the patient's health (hyperoxia episodes), the autonomy of the oxygen device, and the decrease of time out of the home.