The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts


Louis M. Kaufman; Roberts Home Medical, Inc., Germantown, MD

Background: The IOC100P (Invacare, Elyria, Ohio) is a commercially available, cylinder mounted pneumatic oxygen conserving device (OCD). Published specifications and third party bench evaluation indicated it delivers a fixed pulse volume of 43 mL per breath at a setting of 2; higher than many commercially available OCDs. The purpose of this study was to evaluate clinical response and the device setting variability when compared to continuous flow oxygen (CFO) delivery to home based long term oxygen therapy (LTOT) users. Method: Fifty (50) OCDs were obtained for a prescribed patient evaluation and titration by a respiratory therapist (RT). Patients were randomly selected from a group of stable LTOT users. Clinical assessment included oxygen saturation measured by pulse oximeter (SPO2) at the prescribed CFO setting at rest and exertion, defined in this study as performing activities of daily living (ADL) to limitation or a 6 minute walk, whichever came first. The assessment was repeated using the OCD with the device set to maintain equivalent SPO2 at rest and at the same level of exertion. Results: Thirty-two (32) of 68 patients evaluated were effectively titrated for use of the OCD. Failure to consistently trigger was the primary reason patients were unable to tolerate the device. Of the 32 OCD users titrated with exertion, 12 required an OCD setting higher than CFO with exertion, 3 at rest & exertion and 1 required a lower setting with exertion. Seven (14%) of the devices did not work properly at the onset of the study and were returned to the manufacturer for analysis. Testing concluded while every OCD passes a comprehensive end of line test, including bolus size and sensitivity, returned units from this study had some drift in the sensitivity setting that allowed them to be at the high end or outside of the device specification range. Conclusions: Prior published research and our own empirical data suggest >95% of stable LTOT users clinically tolerate OCDs. We hypothesize the sensitivity range of this particular device may have been the reason less patients were effectively titrated. One weakness of the study is the lack or randomization of the evaluation order (CFO first) may have fatigued some patients and altered their tolerance of the OCD. This study re-enforces the prior published research and expert recommendations for assessment and titration of the specific OCD for each patient at rest and with exertion. Sponsored Research - Invacare Corporation