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Q. What can be the contributing factor for the fluctuations in oxygen saturation levels?

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 01, 2017

Hello doctor,

My mother is 97 years old. She had a minor heart failure with a BNP of 110. Recently, she had a bad UTI and asthma. Up to that point, her O2 saturation levels without supplemental oxygen were 95 to 96. Now that she is recovering from UTI, her O2 levels are 97 to 98 with 2 liters of supplemental O2 and her O2 level without supplemental O2 are between 88 and 92. All of these numbers are at rest. She does not do too much activity. What can be the contributing factor to this change? She had a chest CT scan and it did not show COPD. Should she stay on the O2? It is somewhat of a hazard. The tubing is difficult for her to handle. We must have someone with her all the time even throughout the night. We are concerned if she gets up to use the bathroom her foot will get caught on the tubing. She had a complete blood workup done. All the results were normal except that she is anemic. Currently, she is using nebulizer given by the primary care physician containing Ipratropium, Levalbuterol, Budesonide and antibiotics for recurrent UTI.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome to icliniq.com.

I do not understand the correlation between urinary tract infection (UTI) and low oxygen saturation. If the UTI has caused sepsis and multiorgan failure, then only it can affect lungs and saturation would drop.

Asthma is a chronic disease and does not occur suddenly. She either had pre-existing asthma that got exacerbated by UTI or she had acute bronchitis or lower respiratory tract infection.

I would recommend you go for a re-evaluation of her heart by 2D echocardiogram for her ejection fraction and for any signs of pulmonary embolism.

If we do not treat the basic cause of falling saturation, we will not be able to come out of this problem.

I would like to know whether you are treating her at home or hospital. Also, mention if you have her latest blood counts and urine test reports.

For further information consult a pulmonologist online --> https://www.icliniq.com/ask-a-doctor-online/pulmonologist


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Thank you doctor,

My mother went into the hospital with the UTI. I asked for a blood culture, but it was not done. Yes, she had pre-existing asthma. But, it seemed to act up last month only. In the summer and spring, she was fine. We had done an allergy test and also air quality tests were done in our home. They did an echo and her ejection fraction was 55. She is now monitored closely by her primary care physician at home. We do urine cultures as well as analysis quite frequently because of the recurring condition. There is no sign of pulmonary embolism. I asked the pulmonologist at the hospital who reviewed the CT scan. I mentioned to the pulmonologist that I thought she might have had bronchitis but he abruptly said no. I think the UTI sent her into a tailspin. Unfortunately, even though I asked them to do urine cultures at the hospital and continue the antibiotics they failed to do so. What do you think? Her saturation levels are improving so slowly. She tires easily even when her saturations are 98. Two years ago when she had another bad UTI, she was exhausted for quite a while but I never checked her O2 level. Please also let me know if you think whether she could be on the pulse oxygen as opposed to the continuous type. She was discharged from the hospital without any orders accept to follow up with her pulmonologist. The one she went to about 10 months ago has retired and the pulmonologist we want is not available until next month.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome back to icliniq.com.

Do not worry. She has to carry on with oxygen, bronchodilators and diuretics for a long duration. Her lungs may require two to three weeks to show recovery.

It is a good sign that she is maintaining oxygen saturation on oxygen only, otherwise, she would have required biphasic positive airway pressure (BIPAP) support. In such matters, we also use a short course of steroids under antibiotic cover to speed up the recovery.

Make sure that she moves a little bit. If she stays in bed for too long, then she might develop deep vein thrombosis (DVT).

Appoint a physiotherapist for her chest and legs physiotherapy. This is my best opinion for you based on the available details.

For further information consult a pulmonologist online --> https://www.icliniq.com/ask-a-doctor-online/pulmonologist


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