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- Kofod, Linette, 1977-, et al.
(författare)
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Effect of Automated Oxygen Titration during Walking on Dyspnea and Endurance in Chronic Hypoxemic Patients with COPD : A Randomized Crossover Trial
- 2021
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Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 10:21
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Tidskriftsartikel (refereegranskat)abstract
- The need for oxygen increases with activity in patients with COPD and on long-term oxygen treatment (LTOT), leading to periods of hypoxemia, which may influence the patient's performance. This study aimed to evaluate the effect of automated oxygen titration compared to usual fixed-dose oxygen treatment during walking on dyspnea and endurance in patients with COPD and on LTOT. In a double-blinded randomised crossover trial, 33 patients were assigned to use either automated oxygen titration or the usual fixed-dose in a random order in two walking tests. A closed-loop device, O2matic delivered a variable oxygen dose set with a target saturation of 90-94%. The patients had a home oxygen flow of (mean ± SD) 1.6 ± 0.9 L/min. At the last corresponding isotime in the endurance shuttle walk test, the patients reported dyspnea equal to median (IQR) 4 (3-6) when using automated oxygen titration and 8 (5-9) when using fixed doses, p < 0.001. The patients walked 10.9 (6.5-14.9) min with automated oxygen compared to 5.5 (3.3-7.9) min with fixed-dose, p < 0.001. Walking with automated oxygen titration had a statistically significant and clinically important effect on dyspnea. Furthermore, the patients walked for a 98% longer time when hypoxemia was reduced with a more well-matched, personalised oxygen treatment.
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| 2. |
- Kofod, Linette Marie, et al.
(författare)
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Dyspnea and endurance with automated oxygen titration during walking in patients with COPD
- 2021
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 58:Suppl. 65
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: The oxygen need increases with activity in patients with COPD and long-term oxygen treatment (LTOT). Thus, the usual fixed dose given at rest may be insufficient to maintain the oxygen saturation (SpO2), which may influence the patient’s performance. The aim of this study was to evaluate the effect of automated oxygen titration (AOT) compared to usual fixed-dose oxygen treatment during walking on dyspnea and endurance in patients with COPD on LTOT.Method: In a double blinded randomized crossover trial, 33 patients (21 women) performed two Endurance Shuttle Walk Tests (ESWT). One ESWT was performed using a closed-loop device, O2matic® to deliver a variable AOT set at an SpO2-target of 90 to 94% and a flow of 0-15 l/min. The other ESWT was performed using the usual fixed-dose oxygen treatment. The primary outcome was difference in BORG CR10 dyspnea scale in the ESWT at isotimes.Results: The patients had a mean ±SD age of 72.7 ±6.5 years, FEV1 %pred. 31.9 ±11.3 and a home oxygen flow of 1.6 ±0.9 l/min. At last corresponding isotime in the ESWT, the patients reported dyspnea equal to 7.1 ±2.1 with fixed-dose and 4.3 ± 2.0 with AOT, p<0.001. The patients walked on average 6.29 ±3.62 min with fixed-dose and 10.92 ±5.12 min with AOT, p<0.001. AOT kept the patients in target SpO2 level for 56% of the time compared to 12% in the fixed-dose walk.Conclusion: Dyspnea was significantly and clinically relevant reduced during walking when the oxygen level was maintained at SpO2>90%. Furthermore, endurance time increased significantly by 75% by using AOT compared to fixed-dose oxygen. Variable oxygen dosing during activity could lead to meaningful improvements in patients with COPD on LTOT.
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