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. 2016 Nov 25;5(12):108.
doi: 10.3390/jcm5120108.

Monitoring of Physiological Parameters to Predict Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review

Ahmed M Al Rajeh  1 , John R Hurst  2
Affiliations

Monitoring of Physiological Parameters to Predict Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review

Ahmed M Al Rajeh et al. J Clin Med. .

Abstract

Introduction: The value of monitoring physiological parameters to predict chronic obstructive pulmonary disease (COPD) exacerbations is controversial. A few studies have suggested benefit from domiciliary monitoring of vital signs, and/or lung function but there is no existing systematic review.

Objectives: To conduct a systematic review of the effectiveness of monitoring physiological parameters to predict COPD exacerbation.

Methods: An electronic systematic search compliant with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. The search was updated to April 6, 2016. Five databases were examined: Medical Literature Analysis and Retrieval System Online, or MEDLARS Online (Medline), Excerpta Medica dataBASE (Embase), Allied and Complementary Medicine Database (AMED), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and the Cochrane clinical trials database.

Results: Sixteen articles met the pre-specified inclusion criteria. Fifteen of these articules reported positive results in predicting COPD exacerbation via monitoring of physiological parameters. Nine studies showed a reduction in peripheral oxygen saturation (SpO₂%) prior to exacerbation onset. Three studies for peak flow, and two studies for respiratory rate reported a significant variation prior to or at exacerbation onset. A particular challenge is accounting for baseline heterogeneity in parameters between patients.

Conclusion: There is currently insufficient information on how physiological parameters vary prior to exacerbation to support routine domiciliary monitoring for the prediction of exacerbations in COPD. However, the method remains promising.

Keywords: COPD; exacerbation; home monitoring; lung function; physiological signs; telehealth; vital signs.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flow Diagram.
See this image and copyright information in PMC

References

    1. World Health Organization (WHO) Burden of COPD. [(accessed on 24 August 2016)]. Available online: http://www.who.int/respiratory/copd/burden/en/
    1. World Health Organization (WHO) Chronic Obstructive Pulmonary Disease (COPD) 2016. [(accessed on 24 August 2016)]. Available online: http://www.who.int/mediacentre/factsheets/fs315/en/
    1. Murray C.J.L., Lopez A.D. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet. 1997;349:1498–1504. doi: 10.1016/S0140-6736(96)07492-2. - DOI - PubMed
    1. The Global Strategy for the Diagnosis. Management and Prevention of COPD. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016. [(accessed on 22 July 2016)]. Available online: http://www.goldcopd.org/
    1. Hurst J.R., Donaldson G.C., Quint J.K., Goldring J.J.P., Patel A.R.C., Wedzicha J.A. Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: Prospective pilot study. BMC Pulm. Med. 2010;10:52. doi: 10.1186/1471-2466-10-52. - DOI - PMC - PubMed