LATE-BREAKING ABSTRACT: Oxygen titration and weaning with FreeO2 in COPD patients hospitalized for exacerbation. A randomized controlled pilot study

Abstract

Rationale: FreeO2 is an innovative device that automatically adjusts O2 flow to maintain SpO2 within target set by physicians. Main objective was to evaluate whether FreeO2 could be used in daily routine for COPD exacerbations and would be accepted by respiratory ward caregivers. Methods: we conducted a RCT comparing manual and automated O2 adjustment for exacerbated COPD patients admitted to the respiratory ward. We evaluated O2 management perception by nurses and physicians using a visual analogue scale. Patients were monitored for SpO2, respiratory and heart rate, EtCO2. We evaluated time within SpO2 target ±2%, severe desaturation (SpO2 5% above target). Results: 25 patients were included either in each group (n=50). Patients' age was 72±9 yrs, FEV1=1000±500 ml, and initial O2 flow=2.0±1.0 L/min. Oxygen adjustment was quoted 8.9±1.5 and 8.8±1.8 (1=very bad to 10=very good) by nurses under FreeO2 and in the Manual group respectively (P=0.46). Oxygen adjustment was quoted 8.2±2.2 and 7.8±2.1 (P=0.48) by physicians. % time within SpO2 target was 81.2±15.9 with FreeO2 vs 51.3±19.7 with manual adjustment (p<0.001). % time with severe desaturation was 0.2±0.2 vs. 2.3±2.7 (p<0.001) and % time with hyperoxia was 1.5±1.9 vs. 10.4±10.3 (p<0.001). Hospital lenght of stay was 5.8±4.4 days with FreeO2 and 8.4±6.0 in the Manual group (p=0.05). Readmission rate was similar. Conclusions: FreeO2 was well accepted by caregivers, better maintained SpO2 within target, and reduced desaturations and hyperoxia, as compared to Manual adjustment. A lenght of stay reduction may also be observed, although the study was not designed for this sake.