scholarly journals Evaluation of the association of adherence to long-term home oxygen therapy and clinical markers and five-year mortality in patients with Chronic obstructive pulmonary disease

2020 ◽  
Vol 46 (6) ◽  
pp. e20190158-e20190158
Author(s):  
Vitória Klein Marcondes ◽  
Thais Sayuri Kuwazuru ◽  
Luiz Paulo Corrêa e Silva ◽  
Talita Jacon Cezare ◽  
Estefânia Aparecida Thome Franco ◽  
...  
Author(s):  
Marc Daniels ◽  
Jan Philipp Stromps ◽  
Wolfram Heitzmann ◽  
Jennifer Schiefer ◽  
Paul Christian Fuchs ◽  
...  

Abstract There is an increased risk for burn injuries associated with home oxygen therapy of patients with chronic obstructive pulmonary disease since 10 to 50 % of these patients continue to smoke. Enzymatic eschar removal of facial burns is gaining popularity but intubation of this specific patient group often leads to prolonged weaning and can require tracheostomy. This study dealt with the question if enzymatic debridement in these patients can also be performed in analgosedation. A selective review of the literature regarding burn trauma associated with home oxygen use in patients with COPD was performed, as well as a retrospective analysis of all patients with burn injuries associated with home oxygen use and chronic obstructive pulmonary disease that were admitted to the study clinic. In the literature 1746 patients with burns associated with home oxygen use are described, but none of them received enzymatic debridement. In this study seventeen patients were included. All three patients in this study with facial full-thickness burn injuries received enzymatic debridement. The mortality rate in this cohort was 17.6 % (3/17). Up to date, there is limited experience performing regional anesthesia debridement in patients with COPD. This is the first manuscript describing the use of enzymatic debridement in patients with COPD and home oxygen therapy. We could confirm other studies that intubation of these patients leads to prolonged ventilation hours and increases the probability for poor prognosis. Therefore, we described the treatment of enzymatic debridement in analgosedation without intubation.


2018 ◽  
Vol 16 ◽  
pp. 147997231876772 ◽  
Author(s):  
Amélie Gauthier ◽  
Sarah Bernard ◽  
Emmanuelle Bernard ◽  
Serge Simard ◽  
François Maltais ◽  
...  

Long-term oxygen therapy (LTOT) has beneficial effects on survival in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia at rest. Two landmark trials suggested that these benefits depend on the time of exposure to oxygen. Patients are usually prescribed LTOT for at least 15–18 hours/day. The primary objective of this study was to determine the average daily exposure to supplemental oxygen in patients with severely hypoxemic COPD who were newly prescribed LTOT and the proportion of patients who were adherent to their prescription. The secondary objective was to identify predictors of compliance to LTOT. We performed a retrospective observational study of patients newly registered in a regional home oxygen program in Quebec, Canada, between July 1, 2013, and December 31, 2014. Daily exposure to oxygen was objectively measured from the concentrator’s counter clock. From 196 patients registered in the program during the study period, 115 contributed to the analysis. Most patients ( n = 84; 73%) were prescribed oxygen for ≥18 hours/day. Overall, the 115 patients were exposed to home oxygen for 17.8 hours/day; 60% of the patients were compliant according to our definition. Increasing age and ambulatory oxygen utilization predicted adherence to oxygen therapy. Adherence to home oxygen therapy is suboptimal. Behavioral and psychological interventions to improve compliance to LTOT should be investigated.


Sign in / Sign up

Export Citation Format

Share Document