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Diagnosed with pulmonary fibrosis, undergoing physical therapy. Pulse rates drops when sits down. Cause?

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My father in law has been diagnosed with pulmonary fibrosis. He is undergoing home health physical therapy which includes light walking 40 steps or so. My question is this: His pulse ox stays in the upper 80s to low 90s while walking bu then drops rapidly to the low to mid 70s when he sits down. He is on 3 liters o2 at rest and 5liters on exertion? What causes it to drop after exertion?
Posted Sun, 27 Oct 2013 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 1 hour later
Brief Answer:
Exertion increases oxygen demand.

Detailed Answer:
Hi,
Thanks for asking the query on XXXXXXX After going through your query, I would like to comment the following:

1. Your father in law seems to be diagnosed with Pulmonary fibrosis.

2. Pulmonary rehabilitation and Oxygen therapy are very important modalities of treatment in Pulmonary Fibrosis.

3. During exercise or exertion the total oxygen demand of the body increases and hence the oxygen flow has to be increased proportionately during exertion. This is a normal phenomenon for everyone. In a normal individual the body increses the oxygen supply during exertion by hyperventilating i.e. increasing the respiratory rate and tidal volume. However in a pulmonary fibrosis patient the gas exchange mechanism at the interstitium is affected thereby reducing the oxygenation capacity and hence during exertion it is not able to XXXXXXX the increased oxygen demand of the body thus reflecting in the drop of oxygen saturation.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with pulmonary fibrosis, undergoing physical therapy. Pulse rates drops when sits down. Cause? 9 hours later
I understand the need for more oxygen while exerting; however,

what we are not understanding is why the O2 remains stable during exertion but "tanks" when he stops. The O2 level does not drop until he sits down to rest.

It falls rapidly and dramatically until it reaches a low point, then begins to rise. It will return to "normal" within 2-5 minutes after it has bottomed out.
 
 
Answered by Dr. Gyanshankar Mishra 5 hours later
Brief Answer:
Pulse oxymeter has some limitations.

Detailed Answer:
Hi,
Thanks for the follow up.

Does he reduce his respiration rate dramatically after the exertion? Sometime during such transition periods the sudden decrease in respiratory rate takes time to adapt to the oxygen demand which had increased during exercise as both of them do not exactly come down at the same time due to the defective and delayed oxygenation process in pulmonary fibrosis.

Such a temporary fall in spo2 during transition phase should not worry you as long as it reaches the normal level. It signifies the delayed adaptation process between the oxygen supply and demand in the body due to lung fibrosis.

The supplemental oxygen needs to be continued during such process.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with pulmonary fibrosis, undergoing physical therapy. Pulse rates drops when sits down. Cause? 6 hours later
No sure I understand everything but thank you for your time. This is a disease process which is very difficult to understand as there are so many contributory factors. Environmental, underlying medical conditions, etc. Thank you for your time.
 
 
Answered by Dr. Gyanshankar Mishra 1 hour later
Brief Answer:
Thanks for the follow up.

Detailed Answer:
Hi,
Thanks for the follow up.

Considering the disease process, diagnosis of lung Ca and fibrosis and advanced age, the body adaptation does take time.

Continue with the medical care.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
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