Assessing need for long-term oxygen therapy: a comparison of conventional evaluation and measures of ambulatory oximetry monitoring.

BACKGROUND: Appropriate identification of hypoxic patients with chronic obstructive pulmonary disease (COPD) is important because of the demonstrated survival benefit of long-term oxygen therapy (LTOT) and its associated cost. Resting oxygen saturation (measured via pulse oximetry [S(pO2)]) and lowe...

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Publicado en:Respiratory Care Vol. 48; no. 2; pp. 115 - 120
Autores principales: Russell KM, Ayo DS, Branca P, Rogers JT, Rodriguez M, Light RW
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. 2003 Feb
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: Assessing need for long-term oxygen therapy: a comparison of conventional evaluation and measures of ambulatory oximetry monitoring.
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          Russell KM
          Ayo DS
          Branca P
          Rogers JT
          Rodriguez M
          Light RW
        affil: Dept of Pulmonary Medicine, Saint Thomas Hospital and Vanderbilt University, Nashville, TN
      sug:
        subj:
          Ambulatory Care
          Lung Diseases, Obstructive
          Oxygen Saturation Evaluation
          Oxygen Therapy
          Pulse Oximetry
          Aged
          Aged, 80 and Over
          Anoxemia
          Clinical Research
          Comparative Studies
          Convenience Sample
          Correlation Coefficient
          Data Analysis Software
          Descriptive Research
          Descriptive Statistics
          Exercise Test
          Female
          Hospitals
          Linear Regression
          Male
          Middle Age
          Outpatients
          Oximeters
          Prospective Studies
          Sampling Error
          Tennessee
          Human
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: BACKGROUND: Appropriate identification of hypoxic patients with chronic obstructive pulmonary disease (COPD) is important because of the demonstrated survival benefit of long-term oxygen therapy (LTOT) and its associated cost. Resting oxygen saturation (measured via pulse oximetry [S(pO2)]) and lowest exercise S(pO2) (during a 6-min walk test) is the standard method of determining LTOT requirements, but that method does not measure the patient's oxygenation during sleep or activities of daily living. We hypothesized that values obtained via the standard method would correlate poorly with values obtained via ambulatory oximetry monitoring. METHODS: We conducted a prospective, cohort study in an out-patient pulmonary clinic in a tertiary care referral center, with 20 stable COPD patients who were being evaluated for LTOT with conventional evaluation versus 16-24 hours of ambulatory oximetry. RESULTS: The resting S(pO2) did not correlate well with mean ambulatory S(pO2) (r = 0.64) or the percent of monitored time spent with S(pO2) < 88% (r = 0.49). The lowest exercise S(pO2) also did not predict mean ambulatory S(pO2) (r = 0.39) or the percent of monitored time spent with S(pO2) < 88% (r = 0.32). Conventional evaluation overestimated LTOT requirements with 16 of the 20 patients developing an S(pO2) < 88%, most of them with exercise only (ie, most had normal resting S(pO2)). With ambulatory monitoring, however, only 3 of the 16 patients spent > 10% of the monitored time with S(pO2) < 88%. CONCLUSION: There was a poor relationship between the conventional oxygenation assessment method and continuous ambulatory oximetry during LTOT screening with COPD patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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