No description available.

Conjugated linoleic acid (CLA) reduces adipose mass in several species. Studies were conducted to determine: 1) the effect of dietary trans10,cis12-CLA on growth, tissue fatty acid profile, mRNA expression for stearoyl-CoA desaturase (SCD) in adipose and liver, and mRNA expression for fatty acid synthase (FAS) in adipose of mice, 2) the effect of a dietary combination of trans-vaccenic acid (TVA) and trans10,cis12-CLA on delta9- desaturation, and 3) the effect of cis9,trans11-CLA, trans10,cis12-CLA, and carnitine palmitoyltransferase-1 (CPT-1) inhibitors on expression of mRNA for CPT-1 and fatty acid profile in mouse hepatocytes (AML-12) and human hepatoma cells (HepG2). In the first study, male or female mice were fed diets containing 0, 0.15%, or 0.30% trans10,cis12-CLA for 6 wk. Epididymal adipose weights (males) and inguinal adipose weights (females) decreased by 81% and 52%, respectively, in response to 0.30% trans10,cis12-CLA. Dry carcass weights decreased from 4.75 g for the control to 3.62 g for mice fed 0.30% trans10,cis12-CLA and the decrease was due to a reduction in ether extract. Liver weights increased linearly from 0.55 g (control) to 0.65 g (0.30% trans10,cis12-CLA). Dietary trans10,cis12-CLA (0.30%) reduced FAS and SCD mRNA in adipose by 60 and 30 % respectively, compared with the control, suggesting reduced lipogenesis and desaturation might be primary factors responsible for reducing body fat. In the second study, adult male or female mice were fed diets containing 0.40% TVA in combination with 0, 0.15, or 0.30% trans10,cis12-CLA for 10 d. Both TVA and trans10,cis12-CLA were incorporated into plasma, liver, adipose, muscle, and bone lipids proportional to their concentrations in the diets. Desaturation ratios were not affected in adipose, liver, and bone. However, ratios of 16:0 to 16:1 and 18:0 to 18:1 increased from 0.81 to 0.86 and 0.15 to 0.19 respectively, in response to dietary trans10,cis12-CLA (0.30%), suggesting inhibition of delta9 desaturation in muscle. In the third study, AML-12 or HepG2 cells were incubated with control media or media containing 15 uM etomoxir (ETM), 30 uM ETM, 15 uM hemipalmitoylcarnitinium (HPC), 30 uM HPC, 100 uM cis9,trans11-CLA, or 100 uM trans10,cis12-CLA for 24 h. Half the cells were harvested for analysis of fatty acids, mRNA for CPT-1, and cholesterol after 24 h. The remaining cells were incubated for an additional 24 h in control medium. Incorporation (% of total fatty acids) of trans10,cis12-CLA was greater than cis9,trans11-CLA in AML-12 (34 vs 23.6) and HepG2 (28 vs 18) cells. Cells incubated with trans10,cis12-CLA had higher ratios of 16:0 to 16:1, 18:0 to 18:1, and 18:2n6 to 20:4n-6, suggesting inhibition of delta9, delta5 , and delta6 desaturation. Cis9,trans11-CLA also reduced ratio of 18:2n-6 to 20:4n-6 in both cell lines. Trans10,cis12-CLA increased mRNA for CPT-1 in both cell lines compared with the control, suggesting enhanced oxidation of fatty acids. In addition, trans10,cis12-CLA caused a 4-fold and 5-fold increase in free cholesterol content of AML-12 and HepG2 cells, respectively. Overall, results demonstrated that trans10,cis12-CLA modulated lipid metabolism in tissues in vivo and altered fatty acid metabolism, cholesterol synthesis, and CPT-1 mRNA in hepatic cell lines in vitro. / Ph. D.

The efficiency of one fluid displacing another in a permeable medium depends on the pore-scale dynamics at the main wetting front. Experiments have shown that the frontal dynamics can result in two different flow regimes: a sharp and a diffuse front. In the sharp front regime, the displacing fluid occupies nearly all the pores and throats behind the main wetting front and the saturation changes abruptly. In contrast, in the diffuse front regime, pores are filled gradually at the main wetting front, and the saturation change is gradual in space. The different fronts can greatly alter the relative permeability curves, the trapping mechanisms, and the displacement efficiency. Directly measuring the sharpness of the front is difficult. Instead, here we correlate the front sharpness to saturation overshoot, which occurs for moderate to high flux vertical displacements of low density fluid by a higher density fluid in 1-D homogeneous permeable media. We hypothesize the sharpness of wetting front can be explained by competition between two different pore - filling mechanisms (called snap-off and piston-like) with the competition controlled by the velocity of the front and thus the injected flux. We conduct series of infiltration experiments to determine the saturation profile as a function of flux for seven different fluids. We find that for each fluid there is a flux (called overshoot flux) below which saturation overshoot ceases and the front is diffuse. We find that the overshoot flux depends inversely on the invading fluid’s viscosity, and shows little or no dependence on the invading fluid’s surface tension, vapor pressure, and its miscibility with water / text

Research suggests that infants with poor neck and upper torso muscle tone experience lateral slouching and a compromised airway when placed in the semi-upright seating position. Studies reveal that 4-60% of premature infants (born at less than 3-7 weeks gestation) may experience oxygen desaturation events when in their child safety seats (CSS), potentially resulting in adverse neurodevelopmental outcomes. Therefore, the American Academy of Pediatrics recommends that premature infants be tested in their CSS prior to hospital discharge. However, neonatal healthcare providers are concerned that this method of testing might not be reliable. No formal studies have investigated the outcomes of repeat testing of premature infants, and little is known about the risk factors for oxygen desaturation events. Therefore, the purpose of this descriptive, non-experimental, observational study was to explore the stability of the one-point Infant Car Seat Challenge (ICSC) and risk factors that may be associated with oxygen desaturation events. A sample of 49 premature infants was used to explore the following variables: 1) pass/fail rates following two (ICSC) observation points, 2) oxygen saturation and desaturation patterns, sleep/wake activity, and a measure of head lag (using the pull-to-sit maneuver) during two ICSCs, and 3) the association between head lag, chronological age, time spent sleeping in the CSS and oxygen desaturation events. Data were analyzed by descriptive and nonparametric statistical tests. This study's findings indicated that 86% of premature infants had stable results, 8% passed rcsc 1 but not ICSC 2, and 6% failed ICSC l and passed ICSC 2. In addition the odds for oxygen desaturation events increased in infants that are born at a gestational age ≤ 34 weeks, were discharged home at a chronological age of > 7 days and had a corrected gestational age of ≤ 37 weeks. Neither head lag or sleep time influenced the ICSC outcomes. Furthermore the ICSC success rate for identifying at risk infants was equal to or better than that of other screening tests for newborn medical conditions. These findings will assist neonatal healthcare providers in making appropriate recommendations for safe travel.

Background: Pulmonary arterial hypertension (PAH) is a rare but serious disease with symptoms as dyspnea, fatigue and intolerance to exercise. The treatment is mainly pharmacological with physical exercise as an important complement. The 6 minutes walking test (6MWT) is used today worldwide for assessment and follow-up of the PAH patient. Objective: The aim of this study was to, among a PAH-population in Norrland, examine the 6-minutes walking test variables walking distance, ∆dyspnea and Δsaturation according to change over time and correlation between the variables. A further objectice was to examine any differences between four different PAH risk groups according to ∆dyspné och Δsat. Method:  This study is a retrospective register study based on the Umeå/Sundsvall part of the Swedish patient registry SPAHR. A total of 69 patients were examined at the time of diagnosis and at follow-up after 12 ± 3 months regarding 6MWT. Results: A significantly longer walkning distance was measured at follow-up comepared to baseline (284 m (IQR 187-410) vs 322 m (IQR 240 - 435), p < 0,001). A negative but weak correlation existed  at baseline between walking distance and Δsat (r = -0.23, p= 0.022) and at follow-up (r = -0.27, p= 0.033). No significant difference regarding Δsaturation and Δdyspnea could be seen between the risk groups.  Conclusion: Also this study demonstrates that the walking distance is the measure that is seen to vary over time, while Δsaturation and Δdyspnea have not been shown to do so. The weak correlation that could be detected between walking distance and Δsaturation raises the idea that it may be a factor that strengthens or weakens the result measured in meters and could thus possibly increase the informational value of the 6MWT. However, the results of this study indicate that desaturation and estimated dyspnea are not factors that correlate with the walking distance (and thus the patient's functional working capacity). Other variables such as quality of life and fear of movement may need to be estimated by the patient group to be able to evaluate and plan both pharmacological treatment and physical exercise, and to see if it can predict the outcome of the treatment. This should be studied scientifically.

No description available.

UA Open Access Publishing Fund / Background: Noninvasive positive-pressure ventilation (NIPPV) use has increased in the treatment of patients with respiratory failure. However, despite decreasing the need for intubation in some patients, there are no data regarding the risk of intubation-related complications associated with delayed intubation in adult patients who fail NIPPV. The objective of this study is to evaluate the odds of a composite complication of intubation following failed NIPPV compared to patients intubated primarily in the medical intensive care unit (ICU). Methods: This is a single-center retrospective cohort study of 235 patients intubated between 1 January 2012 and 30 June 2013 in a medical ICU of a university medical center. A total of 125 patients were intubated after failing NIPPV, 110 patients were intubated without a trial of NIPPV. Intubation-related data were collected prospectively through a continuous quality improvement (CQI) program and retrospectively extracted from the medical record on all patients intubated on the medical ICU. A propensity adjustment for the factors expected to affect the decision to initially use NIPPV was used, and the adjusted multivariate regression analysis was performed to evaluate the odds of a composite complication (desaturation, hypotension, or aspiration) with intubation following failed NIPPV versus primary intubation. Results: A propensity-adjusted multivariate regression analysis revealed that the odds of a composite complication of intubation in patients who fail NIPPV was 2.20 (CI 1.14 to 4.25), when corrected for the presence of pneumonia or acute respiratory distress syndrome (ARDS), and adjusted for factors known to increase complications of intubation (total attempts and operator experience). When a composite complication occurred, the unadjusted odds of death in the ICU were 1.79 (95% CI 1.03 to 3.12). Conclusions: After controlling for potential confounders, this propensity-adjusted analysis demonstrates an increased odds of a composite complication with intubation following failed NIPPV. Further, the presence of a composite complication during intubation is associated with an increased odds of death in the ICU.

Novas alternativas de produção de ácidos graxos altamente insaturados n-3 (HUFA n-3) são procuradas mediante várias abordagens experimentais na área aquícola considerando que a oferta atual de óleos marinhos é limitada. Como os ácidos graxos das séries n-3 e n-6 são metabolizados mediante os mesmos processos enzimáticos, o aporte de ácidos graxos essenciais da dieta poderia influenciar nos níveis de alongamento e desaturação em função da disponibilidade relativa destes compostos. O objetivo deste trabalho foi determinar a influência de diferentes relações 18:3n3/18:2n6 (ALA/LA - ácido linolênico/ácido linoleico) de rações exclusivamente vegetais, sobre o metabolismo de ácidos graxos de juvenis de pacu (Piaractus mesopotamicus). Inicialmente 18 unidades experimentais (caixas com 16 peixes) foram alimentadas por 34 dias (C1) com uma dieta controle (tratamento T6) contendo óleo de tilápia como único ingrediente de origem animal. Posteriormente, foram formados aleatoriamente, 6 grupos com 3 unidades experimentais cada. Em uma segunda fase, durante 72 dias, 5 grupos receberam dietas, contendo óleo de linhaça e soja em substituição ao óleo de tilápia, com relações calculadas de ALA/LA de: 2,98 (T1); 1,68 (T2); 1,03 (T3); 0,61 (T4) e 0,35 (T5) e um grupo continuou com a dieta controle (T6). Nesta segunda fase, determinaram-se parâmetros de desempenho zootécnico e metabolismo de ácidos graxos em 3 intervalos de 24 dias (C2=58 dias, C3=82 dias e C4=106 dias). Os animais apresentaram crescimento e ganho de peso sem diferenças significativas entre os grupos e com aumento progressivo da proporção de gordura corporal total. A composição de ácidos graxos da dieta influenciou de forma proporcional sobre a composição da maioria de ácidos graxos de corpo inteiro. Os coeficientes de digestibilidade aparente aumentaram conforme o grau de instauração dos ácidos graxos e sua abundância relativa na dieta. A concentração de ácidos graxos polinsaturados nos lipídios de corpo inteiro não diferiu entre a maioria de tratamentos. O teor e aparecimento do ácido graxo 20:5n3 (EPA) e a atividade da enzima Δ-5 desaturase dos grupos T1, T2 e T3 foi menor que os demais tratamentos no período C4. O aparecimento de HUFA n-3 e n-6, atividade Δ-6 desaturase total e atividade Δ-6 desaturase sobre os ácidos graxos n-3 totais dos tratamentos T1 a T5 foram maiores que no T6 (controle). Estes resultados demonstram que o pacu (Piaractus mesopotamicus) é capaz de alongar e desaturar ácidos graxos essenciais para produzir ácidos graxos altamente insaturados (ácidos graxos com no mínimo 20 C e 3 ligações duplas - HUFA). Esta atividade é diminuída pela presença, mesmo em quantidades pequenas, de HUFA na dieta. Além disso, sugerem que relações ALA/LA da dieta, iguais ou maiores que 1, provocam diminuição na taxa de produção de 20:5n3, nos níveis testados neste estudo. / New alternatives for production of highly unsaturated fatty acids n-3 (n-3 HUFA) are sought by various experimental approaches in aquaculture, considering that the current supply of marine oils is limited. Since fatty acids of the n-3 and n-6 series are metabolized by the same enzyme processes, the supply of essential fatty acids of the diet could influence the elongation and desaturation levels, depending on the relative availability of these compounds. The objective of this study was to determine the influence of different 18:3n-3/18:2n-6 ratios (ALA/LA - linolenic acid/linoleic acid) of diets containing exclusively vegetable ingredients on the metabolism of fatty acids, of pacu juveniles (Piaractus mesopotamicus). Initially, 18 experimental units (boxes with 16 animals) were fed a control diet (T6 treatment) containing tilapia oil as the sole animal ingredient for 34 days (C1). Later, 6 groups with 3 experimental units each were formed at random. In a second phase, during 72 days, five groups were fed diets containing linseed and soy oils to replace tilapia oil, with calculated ALA/LA ratios: 2.98 (T1); 1.68 (T2); 1.03 (T3); 0.61 (T4) and 0.35 (T5) and a group continued with the control diet (T6). In the second phase were determined growth performance parameters and fatty acid metabolism in three intervals of 24 days (C2 = 58 days = 82 days and C3 C4 = 106 days). The animals showed growth and weight gain with no significant differences between groups and progressive increase in the proportion of total body fat. The fatty acid composition of the diet influenced proportionally on the composition of the majority of whole body fatty acids. The apparent digestibility increased as the degree of unsaturation of fatty acids and their relative abundance in the diet. The concentration of polyunsaturated fatty acids in whole body lipids did not differ among the most treatments. The content and appearance of the fatty acid 20:5n3 (EPA) and the activity of Δ-5 desaturase enzyme of groups T1, T2 and T3 was lower than the other treatments in C4 period. The appearance of n-3 and n-6 HUFA, Δ 6-desaturase activity and the total Δ 6-desaturase activity on the total n-3 fatty acids from T1 to T5 treatments were higher than T6 (control). These results demonstrate that pacu juveniles are able to elongate and desaturate essential fatty acids to produce highly unsaturated fatty acids. This activity diminishes by the presence of even small amounts of HUFAs in the diet. Moreover, it suggests that ALA/LA ratio of diet, equal to, or greater than one, cause a decrease in the rate of production of 20:5n3, within the levels tested in this study.

Introdução: Pacientes com fibrose cística (FC) comumente apresentam pronunciadas alterações em vias aéreas inferiores, obstrução crônica de vias aéreas superiores, tosse noturna e uso de múltiplas medicações. Desta maneira, estão predispostos a apresentar diminuição da qualidade do sono e distúrbios respiratórios durante o sono. Embora a hipoxemia noturna seja considerada comum e sua identificação relevante no manejo da FC, atualmente ainda restam dúvidas sobre os preditores de dessaturação durante o sono nesta população. Objetivos: 1) Avaliar os distúrbios do sono em uma amostra de pacientes adultos com FC comparando-os com controles saudáveis e 2) Determinar os melhores preditores de dessaturação no sono em pacientes com FC e uma saturação periférica de oxigênio (SpO2) em vigília ≥90%. Métodos: Estudo transversal, com coleta de dados prospectiva, onde foram avaliados pacientes adultos com FC estáveis clinicamente e controles saudáveis pareados por idade e sexo. Todos os indivíduos realizaram uma polissonografia de noite inteira e preencheram a Escala de Sonolência de Epworth (ESE) e o Questionário de Qualidade de Sono de Pittsburgh (PSQI). Os pacientes com FC realizaram função pulmonar, teste de caminhada de 6 minutos (TC6M) e ecocardiografia. Estes dados foram correlacionados com os achados polissonográficos. Resultados: Foram avaliados 51 pacientes com FC (idade média de 25,1 ± 6,7 anos e volume expiratório forçado no primeiro segundo - VEF1 - médio de 57,7 ± 24,7% do previsto) e 25 controles saudáveis. Latências para o início do sono e para o sono REM, eficiência do sono e percentual de estágios do sono não diferiram significativamente entre os grupos. Contudo, pacientes com FC apresentaram maior índice de microdespertares durante o sono (12,1 vs. 8,9; p=0,02) e escores mais elevados na ESE (8,2 vs. 5,6; p=0,002) e no PSQI (6,0 vs. 2,7; p<0,001) em relação aos controles. O índice de apneia-hipopnéia (IAH) foi semelhante entre pacientes com FC e controles e apenas dois pacientes com FC (3,9%) apresentaram critérios polissonográficos para apneia obstrutiva do sono. A dessaturação da oxihemoglobina durante o sono foi significativamente mais frequente nos pacientes com FC comparado aos controles (29,4% vs. 0%; p<0,001). Os pacientes com FC que apresentaram dessaturação no sono tiveram valores mais baixos de SpO2 em vigília e ao final do TC6M, pior função pulmonar e valores mais elevados de pressão sistólica de artéria pulmonar. Em um modelo de regressão logística, identificou-se a SpO2 em vigília como o melhor preditor independente de dessaturação no sono nos pacientes com FC (p<0,001). A SpO2 em vigília <94% apresentou uma sensibilidade, especificidade, valor preditivo positivo e negativo para dessaturação no sono de, respectivamente, 93,3%, 100%, 100% e 97,3%. Conclusões: Pacientes adultos com FC apresentam diminuição subjetiva da qualidade do sono a despeito de uma arquitetura do sono pouco alterada. A dessaturação no sono é comum nos pacientes com FC a despeito de apresentarem uma SpO2 em vigília preservada; não está associada a apneia obstrutiva do sono e pode ser predita acuradamente por uma SpO2 em vigília <94%. / Introduction: Cystic fibrosis (CF) patients may be predisposed to poor sleep quality and sleep disordered breathing due to upper and lower airway abnormalities, chronic cough and use of multiple medications. Though nocturnal hypoxia is considered to be common and its identification relevant for the management of CF, nowadays questions remain about the predictors for sleep desaturation in this population. Objectives: To evaluate sleep parameters in a sample of adult CF patients comparing them with healthy controls and to determine the best predictors of sleep desaturation in CF patients with awake resting peripheral oxygen saturation (SpO2) ≥90%. Methods: In a cross-sectional study, with data collected prospectively, clinically stable adult CF patients and age-matched healthy controls underwent an overnight polysomnography and answered the Epworth sleepiness scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). CF patients had their pulmonary function, six-minute walk test (6MWT) and echocardiography assessed and correlated with polysomnographic findings. Results: Fifty-one CF patients (mean age 25.1 ± 6.7 years; mean FEV1 57.7 ± 24.7% of predicted) and 25 age-matched controls were assessed. CF patients and control subjects had similar sleep latencies, sleep efficiency and percentage of sleep stages. However, CF patients had a higher arousal index during sleep (12.1 vs. 8.9; p=0.02) and had higher ESS (8.2 vs. 5.6; p=0.002) and PSQI (6.0 vs. 2.7; p<0.001) scores than controls. The apnea-hypopnea index was similar in both groups and only two CF patients (3.9%) fulfilled criteria to obstructive sleep apnea. Sleep desaturation was significantly more common in CF patients (29.4% vs 0%; p<0.001). The CF patients who presented sleep desaturation had lower values of awake SpO2 at rest and at the end of 6MWT, worse pulmonary function status and higher pulmonary arterial systolic pressure. In a logistic regression model, we observed that awake resting SpO2 was the single best variable associated with sleep desaturation in CF population (p<0.001). The awake SpO2<94% had a sensitivity, specificity, positive and negative predictive value to sleep desaturation of, respectively, 93.3%, 100%, 100% and 97.3%. Conclusions: CF patients had a worse subjective sleep quality despite small changes in sleep architecture in comparison with age-matched healthy controls. In nonhypoxic, adult CF patients, sleep desaturation is common, is not associated with obstructive sleep apnea and can be accurately predict by awake resting SpO2 <94%.

Objetivo: Estudar o efeito da monitorização contínua da oximetria de pulso (SpO2) durante o teste de caminhada de 6 minutos (TC6m), na detecção da hipoxemia induzida pelo exercício, em pacientes com sintomas respiratórios. Métodos: Os pacientes realizaram testes de função pulmonar e TC6m. A saturação e a freqüência cardíaca foram determinadas por um oxímetro de pulso e os dados transferidos simultaneamente para um computador através de telemetria. Comparamos a menor saturação atingida durante o teste com os valores da SpO2 obtidos imediatamente após o TC6m. Também foram comparadas as diferenças clínico funcionais dos pacientes agrupados de acordo com a presença de dessaturação (SpO2 repouso – SpO2 no exercício 4%) e SpO2 88%. Resultados: Foram estudados 452 pacientes (236 homens, 61 ± 13 anos). A capacidade vital forçada (CVF), o volume expiratório forçado no primeiro segundo (VEF1), a relação VEF1/CVF e a capacidade de difusão pulmonar (DCO) foram respectivamente 65,8 ± 18,6% do previsto, 52,6 ± 23,7% do previsto, 62,8 ± 18,8% e 51,7 ± 20,9% do previsto. A média da SpO2 mínima registrada com auxílio de telemetria durante o TC6m foi de 89,9 ± 6,5% e da SpO2 no final do teste foi de 91,1 ± 6,5% (p<0,001). Em 241 pacientes (53,3%) ocorreu dessaturação no TC6m. Foram observados dois padrões diferenciados de dessaturação durante o exercício: um grupo de pacientes dessaturou no início do TC6m e recuperou a SpO2 antes do final do mesmo (57 pacientes, 23,7% dos pacientes que dessaturaram) e o outro grupo apresentou queda da SpO2 persistente até o final do exercício. A SpO2 basal e os valores de função pulmonar foram significativamente mais altos no grupo de pacientes com o primeiro padrão de dessaturação. A SpO2 foi 88% em 148 pacientes; em 26 destes (17,6%) níveis de SpO2 88% foram detectados somente durante o TC6m. Conclusão: Nosso estudo demonstra que a mensuração contínua da SpO2 durante o TC6m é melhor que a mensuração da SpO2 imediatamente após o teste para detectar dessaturação induzida por exercício. / Objective: To study the effect of continuous measurement of pulse oximetry (SpO2) during six-minute walk test (6MWT) on detection of exercise induced hypoxemia in patients with respiratory complaints. Methods: Patients performed lung function tests and 6MWT. SpO2 and pulse rate were obtained by a pulse oximeter and continuously transferred to a computer using telemetry. The lowest saturation reached during the test was compared with the SpO2 measured immediately after the 6MWT. We also compared functional and clinical differences of patients grouped according to desaturation (rest SpO2 - exercise SpO2 4%) and SpO2 88%. Results: We studied 452 patients (236 men, 61 ± 13 years old). Mean forced vital capacity (FCV), forced expiratory volume in 1 s (FEV1), FEV1/FCV and pulmonary diffusion capacity (DLCO) were 65.8 ± 18.6% of predicted, 52.6 ± 23.7% of predicted, 62.8 ± 18.8% and 51.7 ± 20.9% of predicted, respectively. Mean of lowest SpO2 registered using telemetry during 6MWT was 89.9% ± 6.5% and at the end of test 91.1% ± 6.5% (p<0.001). Desaturation was observed in 241 patients (53.3%). There were two different patterns of desaturation: SpO2 decrease at the beginning of the 6MWT with recovery before the test end (57 patients, 23.7% of the patients with desaturation) and SpO2 decrease maintained at the end of exercise. Rest SpO2 and lung function values were significantly higher in patients with the first desaturation pattern. SpO2 88% was observed in 148 patients; in 26 of these cases (17.6%) SpO2 88% levels were only detected during the 6MWT. Conclusion: Continuous SpO2 measuring is better than SpO2 measurement performed immediately after 6MWT in detecting exercise induced desaturation.