| Abstract | Introduction: Respiratory insufficiency (RI) is a com- plication of several diseases. Long-term oxygen thera- py (LTOT) aims to improve it, withwell known its be- nefits: improvement in quality of life and exercise tole- rance, enhancement of neuropsychological status, pre- vention or delay of pulmonary hypertension, and improvement in survival. Despite all this benefits, values of adherence for LTOT referred in the literature vary between 45 and 70%. Aims: To characterise patients followed at a LTOT outpa- tients clinics of a Pulmonary Diseases Department in a cen- tral Hospital. Presentation of 2 clinical cases. Methods: The authors characterised, retrospectively, all patients followed regularly at a LTOT outpatient's clinic. They were evaluated according to age, gender, diagnosis (main and secondary), smoking habits, co-existence of pulmonary hypertension (PHT) and/or chronic cor pul- monale (CCP), type of RI, criteria to start LTOT, pres- cription and adherence to therapeutics and necessity of ventilator support. To better characterise these patients the authors present a case of an obstructive condition and one of a restrictive condition, both with indication to LTOT. Results: The authors studied 84 patients (20,4% of the to- tal inscribed). The average age at the time of 1st appoint- ment was 72,9+/-9,0 years. Thirty five were female (41,7%) and 49 male (58,3%). Forty eight (57,1%) were smokers or former smokers. Main diagnosis were: chronic obstructive pulmonary di- sease - COPD (49 patients - 58,3%), sequels of pulmo- nary tuberculosis (15 patients - 22,6%), pulmonary in- terstitial diseases (14 patients - 16,7%), bronchiectasias (2 patients - 2,4%), pulmonary vascular diseases (2 pa- tients - 2,4%) and 2 cases (2,4%) that correspond to one patient with hypoventilation obesity syndrome and another one following pneumectomy. These patients pre- sented with multiple serious co-morbidities. Eighteen patients (21,4%) had PHT and 17 (20,2%) CCP. All pa- tients had RI: 35 (41,7%) partial RI and 49 (58,3%) glo- bal RI. Criteria to initiate LTOT were in 60 patients (71,4%) hypo- xemia less than 55 mmHg and in 22 (26,2%) hypoxemia between 55 and 65 mmHg associated with another factor: presence of an elevated haematocrit (n=4 - 4,8%), PHT (n=9 - 10,7%), CCP (n=4 - 4,8%) and association of the 3 (n=4 - 4,8%). Median debit prescribed was 1,4+/-1,6 l/m, being calculated in every patient through an estimate proof (30 minutes). Median time prescribed was 17,3+/-3,7 h/d, being effectively achieved 15,6+/-4,9 h/d. That corresponds to an adherence of 90,2%. Main provision for LTOT was gaseous (n=43 - 51,2%). Fourteen patients (16,7%) also undergo non-invasive ventilation. Conclusion: Patients followed in this outpatient's clinic be- long to an advanced age group, which is consistent with the stage of evolution of the diseases. The most frequent diag- nosis with indication for LTOT was COPD. The main crite- rion was serious RI. The adherence of these patients to oxygen therapy was high, and superior to the media values referred in literature. Key-words: Respiratory insufficiency, long-term oxygen the- rapy, adherence. |
| Authors | F Todo-Bom, M Palla Garcia, M Sousa, R Sotto-Mayor, A Bugalho de Almeida
(Affiliation: Serviço de Pneumologia, Hospital de Santa Maria, Lisboa - Portugal.)
|
| Journal | Revista portuguesa de pneumologia
(Rev Port Pneumol)
Vol. 13
Issue 6 Suppl
Pg. 40-2
(Nov 2007)
ISSN: 0873-2159 Portugal |
| Vernacular Title | Oxigenoterapia de longa duração - Características de uma consulta hospitalar. |
| PMID | 18040571
(Publication Type: English Abstract, Journal Article)
|
