The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


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

Background: Global Initiative for Chronic Obstructive Lung Disease (GOLD) and American Thoracic Society (ATS) guidelines indicate that long-term oxygen therapy (LTOT) patients should either be titrated to an SpO2 of >/= 90% or have oxygen flow increased by 1 L/min during sleep. The purpose of this study was to determine whether LTOT patients whose oxygen dose had not been altered for sleep do experience nocturnal oxygen desaturation while breathing their prescribed oxygen. Method: A retrospective chart review was conducted of 92 consecutive patients with a primary or secondary diagnosis of chronic obstructive pulmonary disease (COPD) who met reimbursement criteria for and were prescribed LTOT for continuous use. There was no difference in their "at rest while awake" and "during sleep" prescribed oxygen flow. A recording pulse oximeter (920M, Philips Respironics, Murrysville, PA) was provided. Patients were instructed to use their prescribed oxygen flow and to apply the pulse oximeter during sleep. Data was extracted using PROFOX Oximetry Software (PROFOX Associates, Escondido, CA). Results: The study group included 33 males and 56 females with a mean age of 73 (range 47 to 94). The study was completed by 89 of the 92 patients; three patients used the pulse oximeter but did not use oxygen during the study. Study times averaged 425 minutes (range 46 minutes to 745 minutes). Oxygen saturation of >/= 89% was maintained throughout the study by 24.7% (22) of the patients; 16.9% (15) of the patients experienced oxygen saturation of < / = 88% for < / = 4 minutes; 58.4% (52) of the patients experienced oxygen saturation of < / = 88% for 5 to 600 minutes. Conclusions: In the majority of patients in this sample, nocturnal oxygen prescriptions which did not vary from "at rest" measurements did not provide adequate oxygen saturation during sleep. This study supports published guidelines which state patients receiving LTOT should either have a nocturnal oxygen titration study or have their oxygen flow increased during sleep.
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