The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

THE USE OF A NEW OXYGEN DELIVERY DEVICE AND WIRELESS CLINICAL OXYGEN DOSE RECORDER FOR MONITORING PATIENTS USING SUPPLEMENTAL OXYGEN

Brian W. Carlin1,2, Chris Brehm2, Victoria Behun2, David Germeyer2; 1Pulmonary and Critical Care Medicine, Allegheny General Hospital, Pittsburgh, PA; 2Lifeline Pulmonary Rehabilitation Centers, Pittsburgh, PA

Background: Significant variability in the delivered dose of oxygen during both rest and exercise has been shown in patients who are oxygen dependent who are undergoing pulmonary rehabilitation. The objective of this study was to monitor patients undergoing pulmonary rehabilitation on their current oxygen device and a novel SmartDose device at rest and during exercise using a new wireless Clinical Oxygen Dose Recorder (CODR, Inspired Technologies, North Huntingdon, PA). Method: Nine patients underwent 6 minute walk testing using their prescribed oxygen dose and again, after a ten minute rest, using a SmartDose algorithm device. The SmartDose device automatically establishes the resting breath rate and increases the dose and flow rate (setting) with rises in respiratory rate during activity. The CODR wirelessly measures and trends the patient’s respiratory rate, I:E ratio, SpO2, Heart rate, and oxygen dose delivered. If the resting oxygen saturation was below 88%, the oxygen flow rate was increased as necessary to maintain the resting saturation above 88%. During each walk, the respiratory parameters were continually recorded and Borg scores were taken at the 1 and 6 minute mark. In addition to SmartDose the other devices measured were HomeFill (Invacare, Elyria, Ohio), Chad Oximatic (Inova, Naples, FL), Airsep (Airsep, Buffalo, NY), Helios (Covidian, Boulder, CO) and continuous flow oxygen. Results: Three patients were unable to complete a full 6 minute walk (SpO2 <88%) with their current home device, however were able to complete the testing on the SmartDose device (SpO2 >88%). Four patients were titrated 2 settings lower on SmartDose (a 5th was titrated 1 setting below) and were able to complete their 6 min walk with an SpO2 > 88%. Six patients were able to maintain SpO2 levels from 1-7% higher than on their home device. All patients reported the same or lower Borg scores on the second walk using the SmartDose device. Conclusions: Current oxygen systems may fail to provide adequate dose delivery and oxygen saturation during exercise. This may impact the patient’s conditioning during rehabilitation. The SmartDose device improved oxygen saturation, in some cases with lower settings, as well as walk duration in patients undergoing rehabilitation. The CODR device is a valuable tool for understanding device titration and patient performance during rehabilitation. Sponsored Research - Study funded by Inspired Technologies, North Huntingdon, Pennsylvania

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