HAPHAZARD USE OF LONG TERM OXYGEN THERAPY

Haphazard Use of Long Term Oxygen Therapy

Haphazard Use of Long Term Oxygen Therapy

Introduction

For numerous COPD patients, prescriptions for and titration of long-run oxygen treatment (LTOT) drop short of therapeutic measures set forward by American Thoracic Society/European Respiratory Society guidelines, as asserted by the outcomes of a study offered at the American College of Chest Physicians 2008 Annual International Assembly. The guidelines state that treatment should be begun if a patient's oxygen saturation is 88% or smaller at rest. During effort, oxygen should be titrated to sustain oxygenation of more than 90%, as asserted by the guidelines. (Pauwels, 2001, 1256)

 

Haphazard Use of Long Term Oxygen Therapy

LTOT declines death and may decrease the risk for exacerbations needing hospitalization in patients with COPD, as asserted by Jason McCarl, MD, of the Department of Medicine at the University of Colorado Health Sciences Center in Denver. However, Dr. McCarl and colleagues discovered that nearly half of the patients registered in their study did not rendezvous suggested goals for ample oxygen treatment, regardless of clinical suggestions that changes were needed. They proposed that oxygen remedy is underprescribed and that added guidelines are required to work out oxygen titration throughout exercise.

     The study encompassed 511 COPD patients (mean age, 68) with stage 3 or 4 COPD as classified by Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria who were registered in an institutional reconsider board-approved COPD trial. All were obtaining remedy from diverse Colorado health amenities, and all but 94 were on oxygen therapy. Twenty per hundred of participants were from country localities, and remainder were built-up residents; 21% of participants were smokers. Patients who smoked and were currently on LTOT tended to have more pack-years than those who were not on oxygen therapy. (Pauwels, 2001, 1256)

     Oxygen saturation as assessed by pulse oximetry (Spo2) was considered throughout rest and after a six-minute stroll test. The investigators discovered that only 2% of those patients who were not on oxygen treatment had Spo2 grades of 88% or less at rest, said Dr. McCarl. “This reflects that providers may be managing a good job of noticing hypoxia at rest in patients not on oxygen therapy.”

     However, amidst the 98% of patients with ample Spo2 grades at rest, “we discovered that a large number of patients—42%—desaturated with workout to an Spo2 of 88% or less, competently mirroring underprescription of oxygen therapy,” Dr. McCarl asserted. (Pauwels, 2001, 1256)

 Among those who were on oxygen treatment, only 8% had Spo2 grades that were subtherapeutic at rest; although, they were not amply titrated to 90%, Dr. McCarl sharp out. Of the 92% who were at therapeutic grades throughout rest, most (58%) became desaturated throughout effort to Spo2 grades of less than 90%.

     In the whole cohort, 6.5% of patients were subtherapeutic at rest, and 54.4% were desaturated with exertion; as a entire, 57.1% of the cohort needed some change of prescription or titration. He accepted that the study outcomes may not be generalizable to other districts ...