Chest
Clinical InvestigationsLong-term Results of Continuous Oxygen Therapy at Sea Level
Section snippets
METHODS AND MATERIALS
We conducted this study and used the criteria for selection of patients according to a protocol we have previously described.5 Briefly, we considered for continuous oxygen therapy any patient with severe COPD, a resting arterial oxygen tension (PaO2) of less than 55 mm Hg while under optimal therapy, and a further decrease in their PaO2 values during treadmill exercise. Administration of 2 liters per minute of oxygen by nasal cannula had to improve the patient's hypoxemia and exercise tolerance.
RESULTS
The group receiving continuous oxygen consisted of 12 men patients with a mean age of 54.9 (±16.5 years, standard deviation). The mean duration of oxygen therapy has been 25.2 months with a range of 4 to 40 months.
DISCUSSION
It is our contention that the expense and demands on physician time to administer continuous oxygen are worthwhile in certain severely ill patients with COPD. If the relatively rapid deterioration in pulmonary function, noted in earlier stages of disease,1, 2 pertained in these patients, such an effort would not be as feasible. Indeed, we noted no significant deterioration in FEV1, FVC, MVV, or DlCOss. That the PaCO2 becomes elevated in some patients following oxygen administration is well
APPENDIX
Approximate cost analysis at Shands Teaching Hospital for 12-day hospitalization for respiratory failure.
Empty Cell Intensive Care Unit (4 days) Ward (semiprivate) (8 days) A. Physician fee Day 1 $ 93.50 — Days 2-4 124.50 — Days 5-12 — $ 208.00 B. Bed fee (including nursing) 700.00 520.00 C. Additional charges (drugs, x-ray, diagnostic tests, consultation) 600.00 400.00 $1,518.00 $1,128.00 Total for hospitalization $2,646.00 Approximate fee per day $ 220.00 Fee for 14.8-day hospitalization $3,260.00 Cost from Coastal
References (37)
- et al.
Long-term course of chronic obstructive pulmonary disease. A new view of the mode of functional deterioration
Am J Med
(1971) Oxygen therapy in diseases of the chest
Br J Dis Chest
(1964)- et al.
Factors affecting prognosis in emphysema
Chest
(1964) - et al.
The Veterans Administration cooperative study of pulmonary function. III. Mortality in relation to respiratory function in chronic obstructive pulmonary disease
Am J Med
(1966) - et al.
Course of chronic obstructive pulmonary disease following first onset of respiratory failure
Chest
(1973) The electrocardiogram in pulmonary emphysema and chronic cor pulmonale
Am Heart J
(1961)- et al.
Maximum utilization of the life table method in analyzing survival
J Chronic Dis
(1958) - et al.
Clinical evaluation of prolonged oxygen therapy in chronic airway obstruction
Am J Med
(1968) - et al.
Course and prognosis of chronic obstructive lung disease. A prospective study of 200 patients
N Engl J Med
(1969) - et al.
The role of long-term continuous oxygen administration in patients with chronic airway obstruction with hypoxemia
Ann Intern Med
(1967)
Long-term continuous oxygen therapy in chronic airway obstruction. Mortality in relationship to cor pulmonale, hypoxia, and hypercapnia
Ann Intern Med
Chronic oxygen therapy
Treatment of chronic obstructive pulmonary disease at sea level Chest
Neuropsychologic effects of continuous oxygen therapy in chronic obstructive pulmonary disease
Chest
The pulmonary diffusing capacity in normal subjects
J Physiol (Lond)
An improved clinical method for the estimation of disturbances of the acid-base balance of human blood
Medicine
Blood gas calculator
J Appl Physiol
Respiratory function tests. Normal values at median altitudes and the prediction of normal results
Am Rev Respir Dis
Comparison of factors regulating red cell 2,3-diphosphoglycerate (2,3 DPG) in acute and chronic hypoxemia
J Lab Clin Med
Cited by (43)
Determinants of quality of life in chronic obstructive pulmonary disease
2013, Revue de Pneumologie Clinique50 Years of psychological research on patients with COPD - Road to ruin or highway to heaven?
2009, Respiratory MedicineCitation Excerpt :Changes (or lack of changes) in pulmonary function following pharmacological treatment do not translate well into changes in subjective well being. In the very first paper in respiratory illness research to focus on quality of life (QOL) as a specific outcome, Stewart et al. reported positive long-term effects on QOL of continuous oxygen therapy in a small sample of patients with severe COPD.29,30 QOL was operationalized using patient diary notes as well as self-reports on improvements in ability to perform daily tasks.
Nocturnal hypoxaemia in patients with chronic obstructive pulmonary disease: who should be treated and how?
1995, Netherlands Journal of MedicineInappropriate use of oxygen: Loss of a valuable healthcare resource
1994, American Journal of the Medical SciencesThe OxyArm™: A supplemental oxygen delivery device
2006, Anesthesia and AnalgesiaCitation Excerpt :The effect of narcotics and postsurgical sedation also affect the nasal cannula delivery (12). There have been anecdotal reports from nursing staff of nasal mucosal trauma resulting from the use of nasal cannulae (8–10). Video monitoring of postsurgical patients has shown that supplemental oxygen is not delivered consistently in the immediate postoperative period because of manipulation and removal of these devices by both patients and nurses for feeding, talking, oral hygiene, and general discomfort (3).
Manuscript received January 10; revision accepted March 17.