scholarly journals Reduced survival in COPD patients who received long-term oxygen therapy without meeting prescription criteria: a preliminary study

2019 ◽  
Author(s):  
François Alexandre ◽  
Alain Varray ◽  
Yannick Stéphan ◽  
Maurice Hayot ◽  
Nelly Héraud
Keyword(s):  
Mortality Risk ◽  
Oxygen Therapy ◽  
Randomized Clinical Trials ◽  
Severe Hypoxemia ◽  
Physiological Basis ◽  
Risk Of Death ◽  
Copd Patients ◽  
Increased Risk ◽  
Long Term Oxygen Therapy

AbstractBackgroundRandomized clinical trials have provided clear evidence that long-term oxygen therapy (LTOT) increases life expectancy in severely hypoxemic COPD patients. However, in real-life settings, in global COPD cohorts, a paradoxical 2-3-fold increased risk of death has been reported in patients under LTOT. This discrepancy could be explained by a subgroup of patients under LTOT who do not meet the current guidelines and for whom LTOT would be associated with poor prognosis. This retrospective study of a global COPD cohort therefore sought to: (1) determine if a subgroup of patients under LTOT without severe hypoxemia could be distinguished, and (2) compare the mortality risk according to hypoxemia severity and LTOT prescription.MethodThe sample was taken from a database (NCT02055885) on 191 stable COPD patients (age: 65.1±9.8 years, 85 women) admitted for a pulmonary rehabilitation program between 2009 and 2012 and followed until 1 January 2018. Uni- and multivariate Cox proportional hazard ratio (HR) models were used to examine the associations between clinical characteristics (age, sex, blood gases, etc.), LTOT according to PaO2 level, and mortality.ResultsForty patients (21%) were under LTOT at PR entry despite not meeting the O2 prescription criteria. Patients under LTOT had a nearly 2-fold higher mortality risk adjusted by covariates (HRmultivariate=1.83; p=0.009). Furthermore, the higher mortality risk under LTOT was specific to the patients under LTOT without severe hypoxemia (HRmultivariate=2.39; p=0.04).ConclusionThe association between LTOT and mortality might be attributed to a subgroup under LTOT despite not/no longer meeting the LTOT criteria. Further studies are needed to identify the physiological basis of this phenomenon.

scholarly journals Long-Term Oxygen Therapy in COPD: evidences and open questions of current indications

2016 ◽  
Vol 73 (1) ◽  
Author(s):  
A. Corrado ◽  
T. Renda ◽  
S. Bertini
Keyword(s):  
Oxygen Therapy ◽  
Supplemental Oxygen ◽  
Future Research ◽  
Chronic Obstructive ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Copd Patients ◽  
Number Of Patients ◽  
Long Term Oxygen Therapy

Long term oxygen therapy (LTOT) has been shown to improve the survival rate in Chronic Obstructive Pulmonary Disease (COPD) patients with severe resting hypoxemia by NOTT and MRC studies, published more than 25 years ago. The improved survival was found in patients who received oxygen for more than 15 hours/day. The effectiveness of LTOT has been documented only in stable COPD patients with severe chronic hypoxemia at rest (PaO255%. In fact no evidence supports the use of LTOT in COPD patients with moderate hypoxemia (55<PaO2<65 mmHg), and in those with decreased oxygen saturation (SO2<90%) during exercise or sleep. Furthermore, it is generally accepted without evidence that LTOT in clinical practice is warranted in other forms of chronic respiratory failure not due to COPD when arterial blood gas criteria match those established for COPD patients. The prescription of oxygen in these circumstances, as for unstable patients, increases the number of patients receiving supplemental oxygen and the related costs. Comorbidities are likely to affect both prognosis and health outcomes in COPD patients, but at the moment we do not know if LTOT in these patients with complex chronic diseases and mild-moderate hypoxemia could be of any use. For these reasons a critical revision of the actual guide lines indications for LTOT in order to optimise effectiveness and costs, and future research in the areas that have not previously been addressed by NOTT and MRC studies, are mandatory.

scholarly journals Impact of adherence to long-term oxygen therapy on patients with COPD and exertional hypoxemia followed for one year

2018 ◽  
Vol 44 (5) ◽  
pp. 390-397 ◽  
Author(s):  
Carolina Bonfanti Mesquita ◽  
Caroline Knaut ◽  
Laura Miranda de Oliveira Caram ◽  
Renata Ferrari ◽  
Silmeia Garcia Zanati Bazan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oxygen Therapy ◽  
Severe Hypoxemia ◽  
Bode Index ◽  
One Year ◽  
Long Term Oxygen Therapy ◽  
Minute Walk

ABSTRACT Objective: To determine the impact of adherence to long-term oxygen therapy (LTOT) on quality of life, dyspnea, and exercise capacity in patients with COPD and exertional hypoxemia followed for one year. Methods: Patients experiencing severe hypoxemia during a six-minute walk test (6MWT) performed while breathing room air but not at rest were included in the study. At baseline and after one year of follow-up, all patients were assessed for comorbidities, body composition, SpO2, and dyspnea, as well as for anxiety and depression, having also undergone spirometry, arterial blood gas analysis, and the 6MWT with supplemental oxygen. The Saint George’s Respiratory Questionnaire (SGRQ) was used in order to assess quality of life, and the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index was calculated. The frequency of exacerbations and the mortality rate were noted. Treatment nonadherence was defined as LTOT use for < 12 h per day or no LTOT use during exercise. Results: A total of 60 patients with COPD and exertional hypoxemia were included in the study. Of those, 10 died and 11 experienced severe hypoxemia during follow-up, 39 patients therefore being included in the final analysis. Of those, only 18 (46.1%) were adherent to LTOT, showing better SGRQ scores, higher SpO2 values, and lower PaCO2 values than did nonadherent patients. In all patients, SaO2, the six-minute walk distance, and the BODE index worsened after one year. There were no differences between the proportions of adherence to LTOT at 3 and 12 months of follow-up. Conclusions: Quality of life appears to be lower in patients with COPD and exertional hypoxemia who do not adhere to LTOT than in those who do. In addition, LTOT appears to have a beneficial effect on COPD symptoms (as assessed by SGRQ scores). (Brazilian Registry of Clinical Trials - ReBEC; identification number RBR-9b4v63 [http://www.ensaiosclinicos.gov.br])

Are COPD Patients with Nocturnal REM Sleep-Related Desaturations More Prone to Developing Chronic Respiratory Failure Requiring Long-Term Oxygen Therapy?

Respiration ◽  
2002 ◽  
Vol 69 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Margherita Sergi ◽  
Maurizio Rizzi ◽  
Arnaldo Andreoli ◽  
Marica Pecis ◽  
Claudio Bruschi ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Rem Sleep ◽  
Oxygen Therapy ◽  
Chronic Respiratory Failure ◽  
Copd Patients ◽  
Long Term Oxygen Therapy

Late Breaking Abstract - Qter® and Creatine improve functional performance in COPD patients on long-term oxygen therapy

2018 ◽  
Author(s):  
Francesca de Blasio ◽  
Bartolome R. Celli ◽  
Francesca Polverino ◽  
Roberta Pastorelli ◽  
Manuela Ferrario ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
Functional Performance ◽  
Copd Patients ◽  
Long Term Oxygen Therapy

Effects of Long-term Oxygen Therapy on Pulmonary Hemodynamics in COPD Patients

CHEST Journal ◽  
1998 ◽  
Vol 113 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Jan Zieliński ◽  
Miroslaw Tobiasz ◽  
Iwona Hawrytkiewicz ◽  
Pawel Sliviński ◽  
Grzegorz Palasiewicz
Keyword(s):  
Oxygen Therapy ◽  
Pulmonary Hemodynamics ◽  
Copd Patients ◽  
Long Term Oxygen Therapy

scholarly journals Long-term oxygen therapy in COPD patients: population-based cohort study on mortality

2018 ◽  
Vol Volume 13 ◽  
pp. 979-988 ◽  
Author(s):  
Nikolay Pavlov ◽  
Alan Haynes ◽  
Armin Stucki ◽  
Peter Jüni ◽  
Sebastian Robert Ott
Keyword(s):  
Cohort Study ◽  
Oxygen Therapy ◽  
Population Based ◽  
Copd Patients ◽  
Long Term Oxygen Therapy

scholarly journals EP.FRI.552 Evaluating short term and long term outcome for patients undergoing emergency laparotomy in comparison to NELA mortality risk calculator

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nourelhuda Darwish ◽  
Elsammoual Mohammed ◽  
Ibrahim Warrag ◽  
AdeelAbbas Dhahri ◽  
Bogdan Ivanov
Keyword(s):  
Mortality Risk ◽  
Emergency Laparotomy ◽  
Risk Calculator ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Uk

Abstract Aim NELA is a project that was introduced in the UK since 2013, aiming to improve quality of care for patients undergoing emergency laparotomy.  NELA mortality risk calculator”was launched in 2017, which estimates the risk of death within 30 days of emergency laparotomy.  Our aim is to determine the short-term (30-day) and long-term (12 months) outcome in patients undergoing emergency laparotomy surgery and compare this with the estimated scores that were documented in the NELA website. Methods This is retrospective study involving patients who underwent emergency laparotomy surgery in the year of 2019. The primary outcome is to determine short-term (30-day) mortality. Results A total of 135 patients were included. The overall 30-day mortality was 8.8% (12/135). 55.77% (78/135) had NELA mortality score of &lt; 5%. Only 1 out of these (1.28%) died within 30 days. (4/78,5.12%) died in 6 to 12 months period of this group. 9 patients (11.53%) had NELA score &gt; 30%, of which 6 (66.66%) died within 30 days and 1 died within 6 months. 26.96% (48/135) had NELA scores 55 to 30%, 5 of them (10.41%) died within 30 days while 7 (14.58%) died within 6-12 months.  Patients with NELA scores more than 5% who survived the operation had higher chance of 30-day complications (25.58%, 11/43), when compared to those with scores less than 5% (11.68%, 9/77). Conclusion NELA mortality score has high accuracy especially if it was &gt;30%. In addition, high NELA scores are associated with increased risk of post operative complications.

scholarly journals Changes in Body Weight and Serum Albumin Levels in Patients Requiring Home Long-term Oxygen Therapy

2021 ◽  
Vol 5 (4) ◽  
pp. 199-206
Author(s):  
Naomi Kayauchi ◽  
Eiji Ojima ◽  
Katsunori Kagohashi ◽  
Hiroaki Satoh
Keyword(s):  
Heart Failure ◽  
Body Weight ◽  
Respiratory Failure ◽  
Chronic Heart Failure ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Oxygen Therapy ◽  
Copd Patients ◽  
Long Term Oxygen Therapy

Purpose: To investigate the long-term changes in body weight and serum albumin levels in patients with respiratory failure, and those with chronic heart failure, who were treated with home long-term oxygen therapy (LTOT) to understand the current status and contribute to future measures. Methods: Patients with chronic obstructive pulmonary disease (COPD), those with interstitial pneumonia (IP), and those with chronic heart failure (CHF) undergoing home LTOT for 6 months or more between January 2011 and January 2019 were included in the study. Body weight and serum albumin levels were assessed at the start of home LTOT and at the end of the observation period, a minimum of 6 months after commencing home LTOT. Results: Sixty-two patients (29 COPDs, 23 IPs, and 10 CHFs) were included. In COPD patients and IP patients, body weight decreased (P = 0.0017, P = 0.0018, respectively, Wilcoxon signed-rank test). Serum albumin levels decreased in IP patients (P = 0.0185) but not in COPD patients. There was neither significant decrease in body weight nor serum albumin levels in patients with CHF. Conclusion: Chronic respiratory failure patients who have home LTOT were likely to have a decreased nutritional status. In order to provide prolonged home LTOT, medical staff need to pay close attention to the nutritional status of patients receiving home LTOT.

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