RT Journal Article
SR Electronic
T1 Automatic Oxygen Titration During Walking in Subjects With COPD: A Randomized Crossover Controlled Study
JF Respiratory Care
FD American Association for Respiratory Care
SP 1456
OP 1464
DO 10.4187/respcare.04406
VO 61
IS 11
A1 François Lellouche
A1 Erwan L'Her
A1 Pierre-Alexandre Bouchard
A1 Cynthia Brouillard
A1 François Maltais
YR 2016
UL http://rc.rcjournal.com/content/61/11/1456.abstract
AB BACKGROUND: Arterial oxygen desaturation frequently occurs in patients with COPD during daily activities at home. Oxygen flow is usually set at fixed and low rates for ambulatory patients. We evaluated an innovative closed-loop system (FreeO2) that automatically adjusts the oxygen flow to the patient's needs in subjects with COPD during walking followed by recovery time, such as during ambulatory conditions.METHODS: Patients with COPD who exhibited oxygen desaturation on exertion were included in the study. Subjects performed endurance shuttle walk tests followed by 10 min of recovery. The tests were conducted in a random order and in crossover with the 3 following conditions: subjects breathing (1) air at 2 L/min, (2) oxygen at 2 L/min, or (3) FreeO2 (variable oxygen flow). SpO2, pulse rate, PETCO2, breathing frequency, and oxygen flow were continuously recorded during the 3 conditions. The primary outcome was the percentage of time within the SpO2 target of 92–96%. Secondary outcomes included the endurance shuttle walk test time and distance.RESULTS: Sixteen subjects with COPD were recruited. The percentage of time with SpO2 in the target range (92–96%) was higher while using the FreeO2, and time with severe oxygen desaturation (SpO2 <88%) was lower with FreeO2 in comparison with constant-flow oxygen and air testing conditions (0.6% vs 23.9% vs 52.2%, P < .001). In comparison with air, walking distance was increased by 35% with oxygen (P = .045) and by 63% with FreeO2 (P < .001). The walking distance was increased by 17% with FreeO2 in comparison with constant oxygen, but the difference was not statistically significant (P = .22).CONCLUSIONS: Automatic titration of oxygen flow during walking to maintain oxygen saturation in a specified range improves oxygenation and may improve exercise tolerance during daily activity, such as walking, in patients with COPD in comparison with room air and fixed oxygen administration. (ClinicalTrials.gov registration: NCT02150434.)