• Aina M Yañez, Dolores Guerrero, Rigoberto Pérez de Alejo, Francisco Garcia-Rio, Jose Luis Alvarez-Sala, Miriam Calle-Rubio, Rosa Malo de Molina, Manuel Valle Falcones, Piedad Ussetti, Jaume Sauleda, Enrique Zamora García, Jose Miguel Rodríguez-González-Moro, Mercedes Franco Gay, Maties Torrent, and Alvar Agustí.
• Fundación de Investigación Sanitaria Illes Balears, Edificio S. Hospital Universitario Son Espases, Palma de Mallorca, Spain. aina.yanez@caubet-cimera.es
• Chest. 2012 Dec 1;142(6):1524-9.

BackgroundRespiratory frequency increases during exacerbations of COPD (ECOPD). We hypothesized that this increase can be detected at home before ECOPD hospitalization.MethodsTo test this hypothesis, respiratory frequency was monitored at home daily for 3 months in 89 patients with COPD (FEV₁, 42.3% ± 14.0%; reference) who were receiving domiciliary oxygen therapy (9.6 ± 4.0 h/d).ResultsDuring follow-up, 30 patients (33.7%) required hospitalization because of ECOPD. In 21 of them (70%), mean respiratory frequency increased (vs baseline) during the 5 days that preceded it (from 15.2 ± 4.3/min to 19.1 ± 5.9/min, P < .05). This was not the case in patients without ECOPD (16.1 ± 4.8/min vs 15.9 ± 4.9/min). Receiver operating characteristic analysis showed that 24 h before hospitalization, a mean increase of 4.4/min (30% from baseline) provided the best combination of sensitivity (66%) and specificity (93%) (area under the curve [AUC] = 0.79, P < .05). Two days before hospitalization, a mean increase of 2.3/min (15% change from baseline) was associated with a sensitivity of 72% and a specificity of 77% (AUC = 0.76, P < .05).ConclusionsRespiratory frequency can be monitored daily at home in patients with COPD receiving domiciliary oxygen therapy. In these patients, breathing rate increases significantly days before they require hospitalization because of ECOPD. This may offer a window of opportunity for early intervention.

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