LOGIN TO YOUR ACCOUNT

Username
Password
Remember Me
Or use your Academic/Social account:

CREATE AN ACCOUNT

Or use your Academic/Social account:

Congratulations!

You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.

Important!

Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message

CREATE AN ACCOUNT

Name:
Username:
Password:
Verify Password:
E-mail:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Ringbaek, Thomas J.; Terkelsen, Jakob; Lange, Peter (2015)
Publisher: Co-Action Publishing
Journal: European Clinical Respiratory Journal
Languages: English
Types: Article
Subjects: COPD; respiratory acidosis; hypercapnic respiratory failure; oxygen therapy; ambulance; pre-hospital care; arterial blood gases; survival; exacerbation, respiratory acidosis, hypercapnic respiratory failure, arterial blood gases, survival, Original Research Article, pre-hospital care, ambulance, COPD, oxygen therapy, exacerbation
Background: Pre-hospital, high-concentration oxygen therapy during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been associated with increased mortality. Recent COPD guidelines have encouraged titrated oxygen therapy with a target saturation range of 88–92%. Oxygen therapy leading to saturation above 92% is defined as ‘inappropriate oxygen therapy’.Objectives: To examine the frequency of inappropriate oxygen therapy and whether inappropriate oxygen therapy in the ambulance in an urban area with short transit time to hospital was associated with poor outcome.Methods: In an audit of 405 consecutive patients with AECOPD arriving by ambulance to Hvidovre Hospital, details of transit time, oxygen administration, saturation, and arterial blood gases were registered. Outcomes were respiratory acidosis, need of supported ventilation, length of hospitalisation, and in-hospital mortality.Results: Only 15 patients were not treated with oxygen and information on oxygen flow was missing in seven patients and on saturation on one patient. Altogether, 352 (88.7%) of 397 patients received inappropriate oxygen therapy. Patients on ‘inappropriate oxygen therapy’ (saturation ≥92%) had a high frequency of respiratory acidosis at hospital admission, 108 (33.5%) of 324 patients, length of stay was on average 5.1 days, 12.5% of the patients needed ventilatory support, and in-hospital mortality was 3.4%.Conclusion: The majority of patients with AECOPD received inappropriate oxygen therapy in the ambulance, but their need of ventilatory support, length of stay, and mortality were low. Randomised studies are needed to clarify the optimal pre-hospital oxygen therapy.Keywords: COPD; respiratory acidosis; hypercapnic respiratory failure; oxygen therapy; ambulance; pre-hospital care; arterial blood gases; survival; exacerbation(Published: 11 May 2015)Citation: European Clinical Respiratory Journal 2015, 2: 27283 - http://dx.doi.org/10.3402/ecrj.v2.27283
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Chenna PR, Mannino DM. Outcomes of severe COPD exacerbations requiring hospitalization. Semin Respir Crit Care Med. 2010; 31: 286 94.
    • 2. Groenerwegen KH, Schols AM, Wouters EF. Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD. Chest. 2003; 124: 459 67.
    • 3. Calverley PM. Oxygen-induced hypercapnia revisited. Lancet. 2000; 356: 1538 9.
    • 4. Campbell E. Respiratory failure: the relation between oxygen concentrations of inspired air and arterial blood gases. Lancet. 1960; 276: 10 1.
    • 5. Plant PK, Owen JL, Elliott MW. One year period prevalence study of respiratory acidosis in acute exacerbations of COPD: implications for the provision of non-invasive ventilation and oxygen administration. Thorax. 2000; 55: 550 4.
    • 6. Wijesinghe M, Perrin K, Healy B, Hart K, Clay J, Weatherall M, et al. Pre-hospital oxygen therapy in acute exacerbation of chronic obstructive pulmonary disease. Intern Med J. 2011; 41: 618 22.
    • 7. Austin MA, Wills KE, Blizzard L, Walters EH, Wood-Baker R. Effect of highflow oxygen on mortality in COPD patients in prehospital setting: randomised controlled trial. BMJ. 2010; 341: c5462.
    • 8. O'Driscoll BR, Howard LS, Davison AG, British Thoracic Society. BTS guideline for emergency oxygen use in adult patients. Thorax. 2008; 63: vi1 68.
    • 9. Beasley R, Patel M, Perrin K, O'Driscoll BR. High-concentration oxygen therapy in COPD. Lancet. 2011; 378: 969 70.
    • 10. O'Driscoll BR, Howard LS, Davison AG, British Thoracic Society. Emergency oxygen use in adult patients: concise guidance. Clin Med. 2011; 11: 372 5.
    • 11. Hale KE, Gavin C, O'Driscoll BR. Audit of oxygen use in emergency ambulances and in a hospital emergency department. Emerg Med J. 2008; 25: 773 6.
    • 12. Gooptu B, Ward L, Ansari SO, Eraut CD, Law D, Davison AG. Oxygen alert cards and controlled oxygen: preventing emergency admissions at risk of hypercapnic acidosis receiving high inspired oxygen concentrations in ambulances and A & E departments. Emerg Med J. 2006; 23: 636 8.
    • 13. Ringbaek T, Lange P, Mogensen T, Fezi S. Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. Ugeskr Laeger. 2008; 170: 1634 8.
    • 14. Denniston AK, O'Brien C, Stableforth D. The use of oxygen in acute exacerbations of chronic obstructive pulmonary disease: a prospective audit of pre-hospital and hospital emergency management. Clin Med. 2002; 2: 449 51.
    • 15. Durrington HJ, Flubacher M, Ramsay CF, Howard LS, Harrison BD. Initial oxygen management in patients with an exacerbation of COPD. Q J Med. 2005; 98: 499 504.
    • 16. Joosten SA, Koh MS, Bu X, Smallwood D, Irving LB. The effects of oxygen therapy in patients presenting to an emergency department with exacerbation of chronic obstructive pulmonary disease. Med J Aust. 2007; 5: 235 8.
    • 17. Roberts CM, Stone RA, Buckingham RJ, Pursey NA, Lowe D, National Chronic Obstructive Pulmonary Disease Resources and Outcomes Project implementation group. Acidosis, noninvasive ventilation and mortality in hospitalised COPD exacerbations. Thorax. 2011; 66: 43 8.
  • No related research data.
  • No similar publications.

Share - Bookmark

Cite this article