Effect Of Long-term Oxygen Therapy Research Articles

Effects of long-term oxygen therapy on the mental state of patients with chronic obstructive pulmonary disease: A systematic review.

This systematic review aimed to examine the effects of long-term oxygen therapy on the mental state of patients with chronic obstructive pulmonary disease. Web of Science, Medline, CINAHL, EMBASE, ProQuest, and Cochrane Library were selected to search for relevant studies. We followed the Cochrane Handbook for Systematic Reviews of Interventions, adopted the Cochrane risk-of-bias tool and Risk Of Bias In Non-randomized Studies of Interventions tool, and synthesized the outcomes narratively with Grading of Recommendations, Assessment, Development and Evaluations evidence profile. Six studies were included. Moderate quality of evidence supported no effects of long-term oxygen therapy on the mental state in patients with severe resting hypoxemia and moderate resting hypoxemia (or exertional desaturation) at follow-up of 6 to 12 months; however, adverse effects on mental state among patients with moderate resting or exertional desaturation were reported at the follow-up of 36 to 48 months. Nurses should focus on the mental state of patients treated with long-term oxygen therapy, especially those who use it for a prolonged time. Due to ethical constraints in this study, a quasi-experimental study with faithful consideration of internal validity can be commenced in the future.

Effect of Long-Term Oxygen Therapy on Reducing Rehospitalization of Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.

The aim of this work is to evaluate whether the addition of home oxygen therapy (HOT) would reduce readmission in chronic obstructive pulmonary disease (COPD) patients. PubMed, ScopeMed, Cochrane, Scopus, and Google Scholar databases were searched. The search strategy used the following keywords "chronic obstructive pulmonary disease", the intervention "long-term oxygen therapy", and the outcome "readmission" combined with the AND operator. The Newcastle-Ottawa Scale and Jadad Scale were used for assessing the quality of cohort studies and clinical trials, respectively. A random-effects model was employed in this study after calculating the standard errors by 95% confidence intervals. The I2 statistic and Cochran's Q-test were used to measure heterogeneity. To address heterogeneity, subgroup analyses were carried out according to the length of LTOT, which was classified as "over 8months" and "under 8months". Seven studies were included in the analysis. In the pooled analysis, the RR [CI95%, p value], heterogeneity criteria for readmission reduced by 1.542 [1.284-1.851, < 0.001], I2 = 60%, and 1.693 [1.645-1.744, < 0.001], I2 = 60% for patients with a length of LTOT treatment under and above 8months, respectively. A sensitivity analysis was conducted by systematically omitting each study, and it showed no influential studies. Egger's test indicated no publication bias (p = 0.64). Based on our results in this systematic review, long-tern oxygen therapy (LTOT) at home was associated with a significantly lower risk ratio of hospital readmission. However, the sample sizes in the studies necessitate larger RCTs to evaluate the effect of LTOT on readmission in COPD patients.

Effect of Long-Term Oxygen Therapy in Chronic Obstructive Pulmonary Disease: A Prospective Clinical Study

Introduction: Long-Term Oxygen Therapy (LTOT) has the potential to improve the mortality and morbidity in Chronic Obstructive Pulmonary Disease (COPD) patients. Aim: To assess the effect of LTOT on the Quality of Life (QoL) in stable COPD patients with severe resting hypoxemia. Materials and Methods: This was a prospective observational study conducted in a tertiary care teaching hospital in Kozhikode, Kerala, on stable COPD patients with severe hypoxemia who were newly initiated on home LTOT for ≥15 hours per day. Health Related Quality of Life (HRQoL), modified Medical Research Council (mMRC) grade of dyspnoea, frequency of exacerbations and adherence to treatment on LTOT were studied. Total of 60 patients were followed-up for one year. Significance of mean was tested using paired t-test and association between qualitative variables was tested using Chi-square test. The p-value &lt;0.05 was considered statistically significant. Results: Out of all, 7 patients died during the study period and 53 patients were included in the final analysis. The mean total St.George’s Respiratory Questionnaire (SGRQ) scores at 3, 6 and 12 months improved to 53.73±13.2, 53.97±13.22 and 54.63±13.16, respectively, from a baseline score of 72.51±8.88. At the end of 12 months of LTOT, 22 (41.51%) patients did not have exacerbations and 31 (58.49%) patients had exacerbations. There was no statistically significant improvement in dyspnoea after one year of LTOT. Among the 53 patients, who completed one year follow-up, 36 (67.92%) participants were adherent and remaining 17 (32.07%) participants were non adherent to LTOT. Conclusion: LTOT improves the HRQoL in stable COPD patients with severe hypoxemia. Use of domiciliary oxygen for at least 15 hours per day can reduce the number of COPD exacerbations.

Long-Term Oxygen Therapy in Patients with Pulmonary Artery Hypertension

Introduction: Dyspnea associated with pulmonary arterial hypertension (PAH) requires supplemental oxygen to maintain oxygen saturation. Many researches related to oxygen therapy in chronic obstructive pulmonary disease and cor pulmonale are available, but the effect of long-term oxygen therapy (LTOT) has not been explored in PAH patients. Aim: This study aimed to determine the effect of LTOT in patients diagnosed with PAH. Methodology: All adult patients with PAH, primary or secondary to respiratory disease who require LTOT, were included in the study. The following parameters were collected: age, gender, severity of PAH based on echocardiogram, body mass index, comorbidities, type of oxygen therapy device, amount and duration of oxygen usage, mortality, frequency of readmission, oxygenation, and vital sign parameters. Results: This was a retrospective study which included 332 participants diagnosed to have PAH after detailed echocardiogram assessment. Out of these, 32 participants were prescribed LTOT at the time of discharge. At the time of discharge, there was a significant improvement in all the vital signs and oxygenation variables. The increase in oxygenation, hemoglobin, and reduced respiratory rate after LTOT was statistically significant (P

Genomics and response to long-term oxygen therapy in chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide, and long-term oxygen therapy has been shown to reduce mortality in COPD patients with severe hypoxemia. However, the Long-term Oxygen Treatment Trial (LOTT), a large randomized trial, found no benefit of oxygen therapy in COPD patients with moderate hypoxemia. We hypothesized that there may be differences in response to oxygen which depend on genotype or gene expression. In a genome-wide time-to-event analysis of the primary outcome of death or hospitalization in 331 subjects, 97 single nucleotide polymorphisms (SNPs) showed evidence of interaction with oxygen therapy at P < 1e-5, including 7 SNPs near arylsulfatase B (ARSB; P = 6e-6). In microarray expression profiling on 51 whole blood samples from 37 individuals, at screening and/or at 12-month follow-up, ARSB expression was associated with the primary outcome depending on oxygen treatment. The significant SNPs were conditional expression quantitative trait loci for ARSB expression. In a network analysis of genes affected by long-term oxygen, two observed clusters including 26 co-expressed genes were enriched in mitochondrial function. Using data from the observational COPDGene Study, we validated the expression of 25 of these 26 genes, plus ARSB. The effect of long-term oxygen therapy in COPD varied based on ARSB expression and genotype. ARSB has previously been shown to be associated with hypoxemia in human bronchial and colonic epithelial cells and in a mouse model. In peripheral blood, long-term oxygen treatment affected expression of mitochondrial-related genes, a biologically relevant pathway in COPD. SNPs and expression of ARSB are associated with response to long-term oxygen in COPD. The ARSB SNPs were expression quantitative trait loci depending on oxygen therapy. Genes differentially expressed by long-term oxygen were enriched in mitochondrial functions. This suggests a potential biomarker to personalize use of long-term oxygen in COPD.

The effects of home oxygen therapy on energy metabolism in patients with COPD.

BackgroundCOPD is preventable and treatable and is characterized by completely nonreversible airflow obstruction. In this study, we aimed to investigate the effect of long-term oxygen therapy on patients with stage 4 COPD who were followed up and treated at the polyclinic or clinic service. We evaluated the effects of oxygen therapy on energy metabolism and physical activity in patients with COPD.MethodsNineteen patients with COPD (16 male/3 female), treated with oxygen therapy for the first time, were included in this study. Analysis of arterial blood gases and pulmonary function test was performed. Metabolic Holter device (SenseWear® Armband) was placed pre- and post-oxygen therapy on the patients’ arm for at least 3 days. This device captures Holter data in a digitized electronic system, and the daily average value was calculated from the data.ResultsPost-oxygen treatment showed a significant increase in energy expenditure by patients with COPD (pretreatment, 1,497±596 joule; posttreatment, 2,977±5,985 joule; P=0.044). Moreover, number of steps during walking (pretreatment, 2,056±256; posttreatment, 2,120±195; P=0.03), resting (pretreatment, 6.36±3.31 hours; posttreatment, 3.47±2.19 hours; P<0.03), and sleeping (pretreatment, 4.23±2.13 hours; posttreatment, 2.33±1.42 hours; P<0.00) showed significant differences. Increased daily energy expenditure in patients with respiratory failure was detected with long-term oxygen therapy. In addition, the immobility of patients decreased and duration of physical activity increased in patients with COPD.ConclusionIn this study, positive effects of long-term oxygen therapy have been demonstrated with respect to energy metabolism and physical activity of patients with COPD. Thus, we recommend that medication adherence and long-term oxygen therapy should begin early in patients with COPD.

Thomas L Petty's lessons for the respiratory care clinician of today.

Because of the importance of his original contributions and their practical relevance today, Thomas L Petty (1932-2009) was arguably the most important physician in the history of respiratory care. As much as any single individual, he was responsible for the concept of intensive and multidisciplinary respiratory care. In the 1960s and 1970s, he made key observations and introduced pioneering therapies in the ICU and in the home. He was the first to describe and name ARDS and to show how to use PEEP to treat life-threatening hypoxemia. He was one of the first anywhere to organize a pulmonary rehabilitation program and to show the beneficial effects of long-term oxygen therapy in COPD. Dr Petty emphasized the importance of practical, hands-on respiratory care education for both physicians and non-physicians using a collaborative team approach. He targeted educational activities and practical resources specifically to patients, and he showed how researchers and clinicians could interact responsibly with innovators in industry to the benefit of both. His life and career provide 6 important lessons for respiratory clinicians today and in the future: (1) whatever their roles, RTs and other clinicians in this field need to be experts in its core areas, such as mechanical ventilation, ARDS, and COPD; (2) respiratory care is a team activity: every member is important, and all the members need to communicate well and work together; (3) education needs to be targeted to those in the best position to benefit the patient, including primary care providers and family members; (4) everyone in the field needs to understand the important role of the respiratory care industry and to deal with it responsibly; (5) it must never be forgotten that it is all about the patient; and (6) respiratory care should be exciting and fun.

Effect of Long-term Oxygen Therapy (LTOT) on Erythropoietin (EPO) Level and Hemoglobin in Patients With Chronic Obstructive Pulmonary Disease (COPD) - A Prospective Study

Effect of Long-term Oxygen Therapy (LTOT) on Erythropoietin (EPO) Level and Hemoglobin in Patients With Chronic Obstructive Pulmonary Disease (COPD) - A Prospective Study

Survey and analysis on the compliance and effect of long-term oxygen therapy among patients with chronic obstructive pulmonary disease and chronic pulmonary heart disease

目的 调查慢性阻塞性肺疾病(COPD)、肺心病患者的氧疗依从性和分析氧疗效果.方法 对山区23个乡村有喘憋症状人群进行入户调查共4 028例,筛查出有K期氧疗指征重型COPD、肺心病患者202例进行氧疗护理干预.结果 18个月后只有50例COPD、肺心病患者长期坚持吸氧.吸氧患者吸氧前和吸氧后比较心电图RV1+SV5有明显变化,肺动脉压、右室内径均较吸氧前明显下降,不吸氧患者明显增高;吸氧患者PaO2、SaO2、FEV1/FVC均显著高于不吸氧患者,PaCO2,明显降低;不吸氧患者住院例数明显高于吸氧患者.结论 长期氧疗可有效地降低肺动脉压,减轻右心负倚,改善心、肺功能,降低住院例数,提高患者的生活质量.护士要加强对氧疗患者的护理干预,提高患者的吸氧依从性。

Long-term oxygen therapy improves health-related quality of life

Guidelines for the prescription of long-term oxygen therapy (LTOT) in hypoxemic COPD patients are based on two landmark studies in which survival was the primary outcome. Such patients are importantly symptomatic with poor health-related quality of life (HRQL) but the effect of LTOT on HRQL remains uncertain. We undertook a prospective longitudinal interventional study of consecutive COPD patients referred to our regional oxygen service; n=43 fulfilling criteria and commenced on LTOT, n=25 not fulfilling criteria and continued on standard care. HRQL was measured at baseline, 2 and 6 months. Both patient groups had severe COPD as defined by mean FEV 1<35% predicted. At baseline the LTOT group demonstrated significantly worse HRQL as defined by the Chronic Respiratory Questionnaire (CRQ) (fatigue, emotional function, mastery and total scores), total generic Dartmouth COOP Charts and anxiety domain of the Hospital Anxiety and Depression scale. Significant improvements in HRQL were noted at 2 and 6 months in the LTOT group. Conversely the non-LTOT group demonstrated a progressive decline in HRQL. Using validated criteria for a minimal clinically significant improvement in CRQ, there were 28 (67%) and 26 (68%) ‘responders’ at 2 and 6 months respectively in the LTOT group. The introduction of LTOT to patients with severe COPD fulfilling standard criteria was associated with early significant improvements in HRQL with sustained or further response at 6 months.

Effect of Long-Term Oxygen Therapy on Cognitive and Neurological Dysfunction in Chronic Obstructive Pulmonary Disease

The aim of this study was to assess effect of long-term oxygen therapy (LTOT) on the function of central and autonomic nervous system in patients with hypoxaemic chronic obstructive pulmonary disease (COPD). A battery of neuropsychological tests was used together with the Short Test of Mental Status in addition to transcranial Doppler ultrasonography, and five cardiovascular tests as well as a questionnaire on autonomic function. Ten COPD patients, 4 males and 6 females, with a mean age of 65.9 ± 7.3 (SD) years, were studied at the beginning and after 3 months of LTOT. At start PaO₂ was 6.7 ± 1.1 kPa without oxygen and 9.9 ± 1.5 kPa after 3 months with oxygen. Our results demonstrate that neuropsychological function, cerebral blood flow velocity and autonomic function were positively influenced after 3 months of LTOT although the changes did not reach statistical significance. The COPD patients were cognitively impaired as compared to age-matched healthy controls. Our findings were consistent with the previous notion of improvement of hypoxic cognitive dysfunction by LTOT.

Effects of long-term oxygen therapy in patients with chronic obstructive pulmonary disease.

Long-term oxygen therapy is largely used in the management of severe hypoxemia in patients with chronic obstructive pulmonary disease. It was demonstrated that long-term oxygen therapy prolongs life, prevents progression of hypoxic pulmonary hypertension, and controls polycythemia. Recent data suggest that in patients with moderate hypoxemia (Pao2 > 55 mm Hg), long-term oxygen therapy does not prolong life. Life expectancy in those patients seems to depend on the severity of airway obstruction. Long-term oxygen therapy improves cognitive functions and emotional status. There is some evidence suggesting that it also improves quality of life, but more data are needed. There are conflicting data concerning the rationale for nocturnal oxygen supplementation in patients with arterial blood desaturation during sleep.

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

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

Effects of Long-term Oxygen Therapy on Pulmonary Hemodynamics in COPD Patients: A 6-Year Prospective Study

To investigate effects of 6 years of domiciliary oxygen therapy on pulmonary hemodynamics in a large group of COPD patients. Prospective longitudinal study with serial measurements. Research institute of pulmonary diseases. Ninety-five patients (72 men, 23 women), mean age 58+/-9 years, had COPD but were free of any other serious disease. Functional characteristics at entry, mean+/-SD, were as follows: FVC=2.24+/-0.51 L; FEV1=0.84+/-0.31 L; PaO2=55+/-6 mm Hg; PaCO2=48+/-9 mm Hg; mean pulmonary arterial pressure (PAP)=28+/-11 mm Hg; and pulmonary vascular resistance (PVR)=353+/-172 dynexsxcm(-5). Pulmonary hemodynamics were investigated using Swan-Ganz thermodilution catheters. After initial assessment, all patients were started on a regimen of long-term oxygen therapy (LTOT). Follow-up consisted of medical examination, spirometry, and arterial blood gas analysis every 3 months. Pulmonary artery catheterization was repeated every 2 years. Seventy-three subjects survived 2 years of LTOT. In 39 subjects catheterized after 2 years, PAP fell from 25+/-8 to 23+/-6 mm Hg (not significant [NS]). From 31 patients who completed 4 years of LTOT, hemodynamic data were obtained in 20. In these 20 patients, PAP averaged 24+/-7 mm Hg at entry, and 23+/-5 and 26+/-6 mm Hg after 2 and 4 years, respectively (NS). In 12 patients who completed 6 years of LTOT, PAP was 25+/-7 at entry, and 21+/-4, 26+/-7, and 26+/-6 mm Hg at 2, 4, and 6 years, respectively (p < 0.01 for 2 vs 6 years). PVR was 313+/-159 dynexsxcm(-5) at entry, and 268+/-110, 344+/-82, and 332+/-205 dynexsxcm(-5) at 2, 4, and 6 years, respectively (NS). During 6 years of follow-up, PaO2 decreased from 61+/-3 to 46+/-9 mm Hg (p < 0.001) and PaCO2 increased from 44+/-13 to 49+/-9 mm Hg (p < 0.01). LTOT for 14 to 15 h/d resulted in a small reduction in pulmonary hypertension after the first 2 years followed by a return to initial values and subsequent stabilization of PAP over 6 years. The long-term stabilization of pulmonary hypertension occurred despite progression of the airflow limitation and of hypoxemia.

Effect of long-term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxaemia.

BACKGROUND: To date only two controlled studies have been published on the effects of domiciliary oxygen treatment on survival in patients with chronic obstructive pulmonary disease (COPD) with advanced respiratory...