Security of removal long- term domiciliary oxygen therapy without indication.

Abstract

Long- term domiciliary oxygen therapy (LTOT) is a therapeutic measure that has been shown to increase survival in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. It is mandatory an annual re-evaluation of the clinican indication, in order to verify compliance and evaluate the clinical impact. A baseline gasometric assessment is required to rule out fictitious severe hypoxemia, which can cause up to 30% of unnecessary prescriptions during hospital discharge. The initial hypothesis of the study was to demonstrate the safety of the LTOT withdrawal (W) after a period of five months of clinical follow-up, as well as to identify the possible subgroups of patients at risk. 57 patients were enrolled to whom LTOT was W due to lack of gasometric indication, with mean age of 80 years and mean pO2 in baseline arterial blood gas at W time was 71.42 mmHg. After this, we registered a died non- related with respiratory failure (RF), and only 10 admissions to emergency department were recorded, less than half with RF (n=3). After five months of clinical follow-up LTOT reintroduction was necessary in 7 patients (12.5%). The W of oxygen therapy based on gasometric criteria is a safe practice 5.23% of our patients re-admitted due to acute respiratory failure after LTOT withdrawal 12.5% of our patients needed the reintroduction of oxygen in an average of 5 months.