The Science Journal of the American Association for Respiratory Care

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 Oprescriptions 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.

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