2006 OPEN FORUM Abstracts
CHANGES IN SUPPLEMENTAL OXYGEN PRESCRIPTION IN PULMONARY REHABILITATION
Trina M. Limberg, BS RCP RRT; Roberta S. Colvin, RN RCP AE-C;
Maria Correa, BS RCP RRT; Rosanna Costello, RCP; Cindy G. Morgan, MS; Andrew L.
Ries, MD MPH University of California, San Diego, CA
Introduction: Adequate O2 therapy plays an important role in the treatment of patients with lung
diseases. Pulmonary rehabilitation (PR) provides an opportunity to fully assess
patients' current O2 prescriptions
and systems, both stationary and portable, during rest and activity. The
purpose of this study was to evaluate the effect of pulmonary rehabilitation
assessment on the O2 prescription.
Methods: The initial evaluation for PR includes an O2
prescription (systems and settings) assessment during rest and activity
(6-minute walk) with the goal of maintaining saturations at ≥ 90%.
Additional O2 assessments were conducted during the program to
confirm the initial findings and were documented in the patient's chart. We
reviewed O2 prescription assessments in 65 consecutive patients with
chronic lung disease admitted to a 6-week pulmonary rehabilitation program [92%
COPD, 54% male, age=70±9 (SD) yrs, FEV1=45±15 % pred., FEV1/FVC=47±13%]. Thirty-eight of 65 (59%) patients required
supplemental O2 either at rest, with activity, or both and are the
subjects of this study.
Results: During pulmonary rehabilitation, 3 of the 38
(8%) patients previously on O2 were taken off O2 and 2 of
the 38 (5%) were prescribed O2 delivery systems and settings to adequately
meet their needs. For stationary systems and settings in the remaining 33 patients
admitted on O2 who stayed on O2, 2 (6%) had system
changes, none had a resting prescription change, and 4 (12%) had prescription
changes for activity. For portable systems in these same 33 patients, 13 (39%)
required total system changes. Of the remaining 20 patients who stayed on the
prescribed system, 1 (3%) had a resting setting change and 6 (18%) required a change in O2
delivery system setting during activity. For the 33 patients who were admitted
on O2 and remained on O2, 18% of patients required some adjustment to their
stationary O2 delivery prescription and 57% of these same patients
required some adjustment in their portable O2 delivery system (one
patient who had a resting setting change also required a setting change during
activity).
Conclusions: Pulmonary rehabilitation provides a valuable
service in assessing supplemental O2
requirements at rest and with activity for patients with chronic lung
diseases. All patients receiving O2 therapy previous to pulmonary
rehabilitation had some type of assessment to receive O2 therapy.
With increased use of O2
therapy, assessment criteria used outside of pulmonary rehabilitation may be
inadequate to meet patient needs. As a result of evaluation with PR staff
facilitating O2 prescription changes, O2
prescriptions were improved for many patients with chronic lung disease.