The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Arianna M. Villa, Alben Lui, Trina Limberg, Catherine Larsen, Maria Baylon, Anne Mohney, Xavier Soler, Andrew Ries; Pulmonary Rehabilitation, UCSD Medical Center, San Diego, CA

BACKGROUND: Oxygen therapy is an important treatment for hypoxemic patients with chronic lung disease, vital to improving activity levels and mobility. During pulmonary rehabilitation (PR), oxygen prescriptions are often found to be incorrect, requiring alteration to meet the patient's oxygen needs. We retrospectively analyzed changes in exercise oxygen prescriptions for patients referred to our PR program. METHODS: A retrospective, observational study was conducted to assess exercise oxygen prescriptions in 60 hypoxemic patients with chronic lung disease before and after participation in the UCSD PR Program. Data collected included age, gender, and clinical information from the patient's medical records, including pulmonary diagnosis based on clinical impression or pulmonary function tests, if available. Oxygen data were obtained from the pre-PR evaluation and the post-PR discharge summary. Data collected included form of oxygen storage (gas vs. liquid), delivery mechanism [oxygen conservation device (OCD) vs. continuous flow], and flow rate (OCD setting vs. L/min continuous flow). Flow rates were classified as high (continuous flow rate 4 L/min or higher or OCD setting #4 or higher) or low (continuous flow 3 L/min or lower or OCD setting #3 or lower). RESULTS: Among the 60 patients, 43 were obstructed, 14 were restricted, and 3 had mixed disease. The number of patients prescribed supplemental oxygen with exercise before and after PR was similar. However, 5 patients had their exercise oxygen discontinued, while 4 had new prescriptions initiated. All were obstructed. The number of patients prescribed high flow oxygen with exercise nearly doubled after PR, both in obstructed and restricted patients. The number of patients using an OCD decreased by 6, most of whom were restricted patients who could not be adequately oxygenated by an OCD device. Patients using compressed gas increased from 47 to 51. CONCLUSIONS: Exercise oxygen prescriptions made prior to PR are often incorrect, and often insufficient to meet patients'needs. 22 of 60 (36.7%) hypoxemic patients required change to higher flow rates and systems that provide more oxygen. Compressed gas systems appear to be more prevalent, especially in those patients requiring high flow rates.
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