Trajectory of the arterial-alveolar oxygen gradient in COPD for a decade.
<h4>Background</h4>Chronic respiratory failure (CRF) is a critical complication in patients with chronic obstructive pulmonary disease (COPD) and is characterized by an increase in the arterial-alveolar oxygen gradient (A-aDO2). The long-term trajectory and prognostic significance remain...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0318377 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1825206796149587968 |
|---|---|
| author | Kazuma Nagata Susumu Sato Kiyoshi Uemasu Naoya Tanabe Atsuyasu Sato Shigeo Muro Toyohiro Hirai |
| author_facet | Kazuma Nagata Susumu Sato Kiyoshi Uemasu Naoya Tanabe Atsuyasu Sato Shigeo Muro Toyohiro Hirai |
| author_sort | Kazuma Nagata |
| collection | DOAJ |
| description | <h4>Background</h4>Chronic respiratory failure (CRF) is a critical complication in patients with chronic obstructive pulmonary disease (COPD) and is characterized by an increase in the arterial-alveolar oxygen gradient (A-aDO2). The long-term trajectory and prognostic significance remain unclear. This study aimed to assess the prognostic impact of A-aDO2 and elucidate its trajectory over ten years.<h4>Methods</h4>We enrolled 170 outpatients with COPD from a prospective cohort study. Arterial blood gas (ABG) analyses were conducted annually for ten years while monitoring the development of CRF.<h4>Results</h4>157 patients completed the observation period, of whom 21 developed CRF (CRF group) and 136 did not (non-CRF group). In the CRF group, there was a gradual increase in A-aDO2 along with decreases in partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) over ten years, although there were no changes in the non-CRF group. The CRF group had higher baseline A-aDO2 and higher ΔA-aDO2 in the first year than the non-CRF group (3.76 vs. 0.42 Torr/year, p = 0.030). Kaplan-Meier analyses, and multivariate Cox proportional hazards analysis revealed that both baseline A-aDO2 and ΔA-aDO2 were significantly associated with the development of CRF. Retrospective tracking from the initiation of long-term oxygen therapy (LTOT) revealed significant increases in A-aDO2 from 5 years prior to LTOT initiation in the CRF group when compared to the non-CRF group.<h4>Conclusions</h4>An increasing trend in A-aDO2 may be a significant sign for the future development of CRF. A transition of the annual change of A-aDO2 from a stable state to a deterioration phase can serve as a prognostic factor for developing CRF within 5 years. |
| format | Article |
| id | doaj-art-7afc836d618e41ce934f6eec5c975d9f |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-7afc836d618e41ce934f6eec5c975d9f2025-02-07T05:30:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01201e031837710.1371/journal.pone.0318377Trajectory of the arterial-alveolar oxygen gradient in COPD for a decade.Kazuma NagataSusumu SatoKiyoshi UemasuNaoya TanabeAtsuyasu SatoShigeo MuroToyohiro Hirai<h4>Background</h4>Chronic respiratory failure (CRF) is a critical complication in patients with chronic obstructive pulmonary disease (COPD) and is characterized by an increase in the arterial-alveolar oxygen gradient (A-aDO2). The long-term trajectory and prognostic significance remain unclear. This study aimed to assess the prognostic impact of A-aDO2 and elucidate its trajectory over ten years.<h4>Methods</h4>We enrolled 170 outpatients with COPD from a prospective cohort study. Arterial blood gas (ABG) analyses were conducted annually for ten years while monitoring the development of CRF.<h4>Results</h4>157 patients completed the observation period, of whom 21 developed CRF (CRF group) and 136 did not (non-CRF group). In the CRF group, there was a gradual increase in A-aDO2 along with decreases in partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) over ten years, although there were no changes in the non-CRF group. The CRF group had higher baseline A-aDO2 and higher ΔA-aDO2 in the first year than the non-CRF group (3.76 vs. 0.42 Torr/year, p = 0.030). Kaplan-Meier analyses, and multivariate Cox proportional hazards analysis revealed that both baseline A-aDO2 and ΔA-aDO2 were significantly associated with the development of CRF. Retrospective tracking from the initiation of long-term oxygen therapy (LTOT) revealed significant increases in A-aDO2 from 5 years prior to LTOT initiation in the CRF group when compared to the non-CRF group.<h4>Conclusions</h4>An increasing trend in A-aDO2 may be a significant sign for the future development of CRF. A transition of the annual change of A-aDO2 from a stable state to a deterioration phase can serve as a prognostic factor for developing CRF within 5 years.https://doi.org/10.1371/journal.pone.0318377 |
| spellingShingle | Kazuma Nagata Susumu Sato Kiyoshi Uemasu Naoya Tanabe Atsuyasu Sato Shigeo Muro Toyohiro Hirai Trajectory of the arterial-alveolar oxygen gradient in COPD for a decade. PLoS ONE |
| title | Trajectory of the arterial-alveolar oxygen gradient in COPD for a decade. |
| title_full | Trajectory of the arterial-alveolar oxygen gradient in COPD for a decade. |
| title_fullStr | Trajectory of the arterial-alveolar oxygen gradient in COPD for a decade. |
| title_full_unstemmed | Trajectory of the arterial-alveolar oxygen gradient in COPD for a decade. |
| title_short | Trajectory of the arterial-alveolar oxygen gradient in COPD for a decade. |
| title_sort | trajectory of the arterial alveolar oxygen gradient in copd for a decade |
| url | https://doi.org/10.1371/journal.pone.0318377 |
| work_keys_str_mv | AT kazumanagata trajectoryofthearterialalveolaroxygengradientincopdforadecade AT susumusato trajectoryofthearterialalveolaroxygengradientincopdforadecade AT kiyoshiuemasu trajectoryofthearterialalveolaroxygengradientincopdforadecade AT naoyatanabe trajectoryofthearterialalveolaroxygengradientincopdforadecade AT atsuyasusato trajectoryofthearterialalveolaroxygengradientincopdforadecade AT shigeomuro trajectoryofthearterialalveolaroxygengradientincopdforadecade AT toyohirohirai trajectoryofthearterialalveolaroxygengradientincopdforadecade |