scholarly journals Long-Term Oxygen Therapy in COPD: evidences and open questions of current indications

2016 ◽  
Vol 73 (1) ◽  
Author(s):  
A. Corrado ◽  
T. Renda ◽  
S. Bertini
Keyword(s):  
Oxygen Therapy ◽  
Supplemental Oxygen ◽  
Future Research ◽  
Chronic Obstructive ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Copd Patients ◽  
Number Of Patients ◽  
Long Term Oxygen Therapy

Long term oxygen therapy (LTOT) has been shown to improve the survival rate in Chronic Obstructive Pulmonary Disease (COPD) patients with severe resting hypoxemia by NOTT and MRC studies, published more than 25 years ago. The improved survival was found in patients who received oxygen for more than 15 hours/day. The effectiveness of LTOT has been documented only in stable COPD patients with severe chronic hypoxemia at rest (PaO255%. In fact no evidence supports the use of LTOT in COPD patients with moderate hypoxemia (55<PaO2<65 mmHg), and in those with decreased oxygen saturation (SO2<90%) during exercise or sleep. Furthermore, it is generally accepted without evidence that LTOT in clinical practice is warranted in other forms of chronic respiratory failure not due to COPD when arterial blood gas criteria match those established for COPD patients. The prescription of oxygen in these circumstances, as for unstable patients, increases the number of patients receiving supplemental oxygen and the related costs. Comorbidities are likely to affect both prognosis and health outcomes in COPD patients, but at the moment we do not know if LTOT in these patients with complex chronic diseases and mild-moderate hypoxemia could be of any use. For these reasons a critical revision of the actual guide lines indications for LTOT in order to optimise effectiveness and costs, and future research in the areas that have not previously been addressed by NOTT and MRC studies, are mandatory.

scholarly journals Clinical features of Japanese patients with exacerbations of chronic obstructive pulmonary disease

2020 ◽  
Author(s):  
Hiroki Tashiro ◽  
Yuki Kurihara ◽  
Koichiro Takahashi ◽  
Hironori Sadamatsu ◽  
Tetsuro Haraguchi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Oxygen Therapy ◽  
Chronic Obstructive ◽  
Severe Exacerbation ◽  
Exacerbation Rate ◽  
Stable Period ◽  
Copd Patients ◽  
Blood Eosinophils ◽  
Long Term Oxygen Therapy

Abstract BackgroundExacerbations are critical events in chronic pulmonary obstructive disease (COPD). The frequency of COPD exacerbations is associated with the prognosis, including mortality, but no useful biomarker has been established.MethodsThe present retrospective study investigated 481 COPD patients. Clinical features in the stable period were compared between patients who experienced severe exacerbation (n=88, 18.3%) and those who never experienced severe exacerbation (n=393, 81.7%). In the patients who experienced exacerbations, clinical features were also compared between frequent exacerbators (exacerbation rate ≥ 2 times/year, n=27, 30.7%) and infrequent exacerbators (1 time/year, n=61, 69.3%).ResultsCompared to COPD patients who never experienced exacerbations, body mass index (BMI), serum albumin, and pulmonary functions were significantly lower, and the cardiovascular disease comorbidity rate, COPD assessment test score, modified Medical Research Council dyspnea scale, and use of long-term oxygen therapy, long-acting β2 adrenergic agonist therapy, inhaled corticosteroid therapy, and macrolide therapy were significantly higher in COPD patients with exacerbations (all p < 0.01). In patients who experienced exacerbations, frequent exacerbators had significantly lower % forced expiratory volume in 1.0 second and a higher risk of critical exacerbations, percentage of blood eosinophils, history of mechanical ventilation use, and use of long-term oxygen therapy and of macrolide therapy than infrequent exacerbators (all p < 0.01). On multivariate analysis, the percentage of blood eosinophils was the parameter most correlated with exacerbation frequency (β value [95% confidence interval] 1.45 [1.12 – 1.88], p < 0.01).ConclusionBlood eosinophil in the stable period is the factor most correlated with the frequency of severe exacerbations.

scholarly journals Six-year survival of patients with severe respiratory failure treated with long-term oxygen therapy at home

2005 ◽  
pp. 81-83
Author(s):  
A. R. Tatarsky ◽  
A. E. Baskakova
Keyword(s):  
Respiratory Failure ◽  
Oxygen Therapy ◽  
Control Group ◽  
Chronic Obstructive ◽  
Severe Respiratory Failure ◽  
Copd Patients ◽  
The Mean ◽  
Long Term Oxygen Therapy ◽  
At Home

Long-term oxygen therapy (LTOT) improves survival of patients with chronic obstructive pulmonary disease (COPD) having severe respiratory failure and chronic hypoxemia. In our study 51 patients received LTOT at home via concentrators (34 males, the mean age, 65.5 ± 7.8 yrs; 17 females, the mean age, 62.8 ± 4.1 yrs). Of them, 37 (72.5 %) survived 6-year period and 14 died (13 males and 1 female). Causes of death were acute respiratory viral infection (in 1 patient), insult (in 1 patient), chronic heart and lung failure (in 12 patients). Survival of patients with chronic restrictive pulmonary diseases was not longer than 3 years. A control group included 45 COPD patients with severe respiratory failure not receiving LTOT (30 males, the mean age, 66.3 ± 8.5 yrs; 15 females, the mean age, 69.1 ± 4.6 yrs). Of them, 16 survived 6 years and 29 died (5 females, the mean age, 72.6 ± 3.6 yrs, 24 males, the mean age, 67.8 ± 5.2 yrs). So, LTOT at home improves survival of COPD patients with severe respiratory failure.

scholarly journals Dietary Behaviour and Nutrition in Patients with COPD Treated with Long-Term Oxygen Therapy

2021 ◽  
Vol 18 (23) ◽  
pp. 12793
Author(s):  
Dominika Mekal ◽  
Aleksandra Czerw ◽  
Andrzej Deptala
Keyword(s):  
Oxygen Therapy ◽  
Daily Intake ◽  
Airflow Obstruction ◽  
Dietary Behaviour ◽  
Chronic Obstructive ◽  
Obese Patients ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Long Term Oxygen Therapy

Background: It is the first study in Poland and one of the first in the world to assess the nutrition of patients with chronic obstructive pulmonary disease (COPD) treated with long-term oxygen therapy (LTOT). Methods: The study group consisted of 110 COPD patients treated with LTOT. Anthropometric measurements and spirometry were performed. The diet of patients was assessed using a 3-day nutrition diary. Results: When assessing the degree of airflow obstruction (FEV1% N) depending on the BMI in patients treated with LTOT, a statistically significant correlation was demonstrated between the BMI and the value of the FEV% N parameter (p = 0.0093). Patients with COPD with a BMI >30 had statistically significantly higher values of FEV1% N than patients with a BMI in the range of 20–24.9 (p = 0.0278). Intake of calcium, vitamins A, C, D, E and folates was lower than the recommended daily intake in more than 95% of COPD patients. Conclusions: The diet of COPD patients treated with long-term oxygen therapy was improperly balanced, with deficiencies of important nutrients. Airflow obstruction in the respiratory tract was significantly smaller in obese patients, and greater in patients with diagnosed malnutrition.

scholarly journals Clinical features of Japanese patients with exacerbations of chronic obstructive pulmonary disease

2020 ◽  
Author(s):  
Hiroki Tashiro ◽  
Yuki Kurihara ◽  
Koichiro Takahashi ◽  
Hironori Sadamatsu ◽  
Tetsuro Haraguchi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Oxygen Therapy ◽  
Chronic Obstructive ◽  
Severe Exacerbation ◽  
Exacerbation Rate ◽  
Stable Period ◽  
Copd Patients ◽  
Blood Eosinophils ◽  
Long Term Oxygen Therapy

Abstract BackgroundExacerbations are critical events in chronic pulmonary obstructive disease (COPD). The frequency of COPD exacerbations is associated with the prognosis, including mortality, but no useful biomarker has been established.MethodsThe present retrospective study investigated 481 COPD patients. Clinical features in the stable period were compared between patients who experienced severe exacerbation (n=88, 18.3%) and those who never experienced severe exacerbation (n=393, 81.7%). In the patients who experienced exacerbations, clinical features were also compared between frequent exacerbators (exacerbation rate ≥ 2 times/year, n=27, 30.7%) and infrequent exacerbators (1 time/year, n=61, 69.3%).ResultsCompared to COPD patients who never experienced exacerbations, body mass index (BMI), serum albumin, and pulmonary functions were significantly lower, and the cardiovascular disease comorbidity rate, COPD assessment test score, modified Medical Research Council dyspnea scale, and use of long-term oxygen therapy, long-acting β2 adrenergic agonist therapy, inhaled corticosteroid therapy, and macrolide therapy were significantly higher in COPD patients with exacerbations (all p < 0.01). In patients who experienced exacerbations, frequent exacerbators had significantly lower % forced expiratory volume in 1.0 second and a higher risk of critical exacerbations, percentage of blood eosinophils, history of mechanical ventilation use, and use of long-term oxygen therapy and of macrolide therapy than infrequent exacerbators (all p < 0.01). On multivariate analysis, the percentage of blood eosinophils was the parameter most correlated with exacerbation frequency (β value [95% confidence interval] 1.45 [1.12 – 1.88], p < 0.01).ConclusionBlood eosinophil in the stable period is the factor most correlated with the frequency of severe exacerbations.Trial registrationThe patients in this study was registered retrospectively

scholarly journals Long-Term Oxygen Therapy in COPD: Factors Affecting and Ways of Improving Patient Compliance

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Stamatis Katsenos ◽  
Stavros H. Constantopoulos
Keyword(s):  
Oxygen Therapy ◽  
Clinical Effectiveness ◽  
Review Article ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Copd Patients ◽  
Long Term Oxygen Therapy

Long-term oxygen therapy (LTOT) is the cornerstone mode of treatment in patients with severe chronic obstructive pulmonary disease (COPD) associated with resting hypoxaemia. When appropriately prescribed and correctly used, LTOT has clearly been shown to improve survival in hypoxemic COPD patients. Adherence to LTOT ranges from 45% to 70% and utilization for more than 15 hours per day is widely accepted as efficacious. Although several studies have addressed the level of patients' adherence to LTOT, few have suggested or evaluated interventions that conduce to compliance enhancement. The lack of sufficient data regarding COPD patients following oxygen prescription is an enormous void that must be duly confronted to augment clinical effectiveness and cost containment for the long term use. The present review article highlights factors influencing the compliance of patients using LTOT and emphasizes novel strategies and interventions that may prove to be of significant benefit given the remarkably little current research appraising this issue. Therefore, additional research should be promptly performed to verify the efficacy of newly designed approaches in improving the outcomes of patients receiving LTOT.

scholarly journals Improving home oxygen therapy in patients with interstitial lung diseases: application of a noninvasive ventilation device

2020 ◽  
Vol 14 ◽  
pp. 175346662096302
Author(s):  
Sandra Cuerpo ◽  
Maria Palomo ◽  
Fernanda Hernández-González ◽  
Joel Francesqui ◽  
Nuria Albacar ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Noninvasive Ventilation ◽  
Exercise Tolerance ◽  
Oxygen Therapy ◽  
Arterial Oxygen Saturation ◽  
Interstitial Lung Diseases ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Long Term Oxygen Therapy

Background: Proper adjustment of arterial oxygen saturation (SaO2) during daily activities in patients with interstitial lung disease (ILD) requiring long-term oxygen therapy is challenging. Given the multifactorial nature of the limited exercise tolerance in patients with ILDs, the isolated use of oxygen therapy may not be enough. As demonstrated previously in patients with chronic obstructive pulmonary disease, the use of a noninvasive ventilation (NIV) device combined with oxygen therapy may prevent the falling of oxygen saturation during exercise, due to an improvement of the ventilation–perfusion ratio and a reduction of the respiratory work, thus enhancing exercise tolerance. We sought to assess in patients diagnosed with ILD who are in need of oxygen therapy, the effect of associating an NIV to improve oxygen parameters and the distance covered during the 6 min walking test (6MWT). Methods: We conducted a prospective observational study in patients with ILDs. After a clinical characterization, we performed a 6MWT in two different situations: using a portable oxygen concentrator with the regular flow used by the patient during their daily life activities and afterwards adding the additional support of a NIV. The oxygen saturation parameters were registered with a portable oximeter. Results: We included 16 patients with different ILDs who have oxygen therapy prescribed. The use of NIV associated with oxygen therapy in comparison with the use of oxygen therapy alone showed an increase of the average SaO2 [91% (88–93) versus 88% (86–90%); p = 0.0005] and a decrease in the percentage of time with oxygen saturation <90%: 36% (6–56%) versus 58% (36–77%); p < 0.0001. There were no changes in the 6MWT distance: 307 m (222–419 m) versus 316 m (228–425 m); p = 0.10. Conclusions: In our study the use of a NIV system associated with long-term oxygen therapy during exercise showed beneficial effects, especially improvement of oxygen saturation. The reviews of this paper are available via the supplemental material section.

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