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Yoon JS, Khoo KH, Puthumana JS, Pérez Rivera LR, Keller PR, Lagziel T, Cox CA, Caffrey J, Galiatsatos P, Hultman CS. Outcomes of Patients with Burns Associated with Home Oxygen Therapy: An Institutional Retrospective Review. J Burn Care Res 2022; 43:1024-1031. [DOI: 10.1093/jbcr/irac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Home oxygen therapy (HOT) burns carry high morbidity and mortality. Many patients are active smokers, which is the most frequent cause of oxygen ignition. We conducted a retrospective review at our institution to characterize demographics and outcomes in this patient population. An IRB-approved single-institution retrospective review was conducted for home oxygen therapy burn patients between July 2016 and January 2021. Demographic and clinical outcome data were compared between groups. We identified 100 patients with oxygen therapy burns. Mean age was 66.6 years with a male to female ratio of 1.3:1 and median burn surface area of 1%. In these patients, 97% were on oxygen for COPD and smoking caused 83% of burns. Thirteen were discharged from the emergency department, 35 observed for less than 24 hours, and 52 admitted. For admitted patients, 69.2% were admitted to the ICU, 37% required intubation, and 11.5% required debridement and grafting. Inhalational injury was found in 26.9% of patients, 3.9% underwent tracheostomy, and 17.3% experienced hospital complications. In-hospital mortality was 9.6% and 7.7% were discharged to hospice. 13.5% required readmission within 30 days. Admitted patients had significantly higher rates of admission to the ICU, intubation, and inhalational injury compared to those that were not admitted (p < .01). Most HOT-related burns are caused by smoking and can result in significant morbidity and mortality. Efforts to educate and encourage smoking cessation with more judicious HOT allocation would assist in preventing these unnecessary highly morbid injuries.
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Affiliation(s)
- Joshua S Yoon
- Division of Plastic, Reconstructive & Maxillofacial Surgery, R Adams Cowley Shock Trauma Center , Baltimore, MD USA
- Department of Surgery, George Washington University Hospital , Washington, DC USA
| | - Kimberly H Khoo
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
| | - Joseph S Puthumana
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
| | | | - Patrick R Keller
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
| | - Tomer Lagziel
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
| | - Carrie A Cox
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - Julie Caffrey
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - Panagis Galiatsatos
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University , Baltimore, MD USA
| | - C Scott Hultman
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
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Portable Oxygen Therapy: Is the 6-Minute Walking Test Overestimating the Actual Oxygen Needs? J Clin Med 2020; 9:jcm9124007. [PMID: 33322352 PMCID: PMC7764027 DOI: 10.3390/jcm9124007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 01/07/2023] Open
Abstract
The appropriate titration for the personalized oxygen needs of patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia is a determining factor in the success of long-term oxygen therapy. There are no standardized procedures to assist in determining the patient’s needs during the physical activities of daily life. Despite that effort tests are a wide broad approach, further research concerning the development of protocols to titrate O2 therapy is needed. The main objective of this study was to assess whether the level of oxygen titrated through the 6-minute walking test (6MWT) for patients with COPD and exertional hypoxemia is adequate to meet the patients’ demand during their activities of daily living. Physiological and subjective variables were estimated for a study population during two walking tests: a 6MWT and a 20-minute walking circuit (20MWC), designed ad-hoc to reproduce daily physical activities more truthfully. The results indicate that in a significant proportion of patients, the 6MWT might not accurately predict their oxygen needs at a domiciliary environment. Therefore, the titration of the portable O2 therapy could not be optimal in these cases, with the detrimental impact on the patient’s health (hyperoxia episodes), the autonomy of the oxygen device, and the decrease of time out of the home.
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Peña JB, Ávila Valencia JC, Assis JK, Gutiérrez HH, Córdoba VB. Benefits of Pulmonary Rehabilitation in Patients with COPD with Use and without the Use of Supplemental Oxygen During Exercise. CURRENT RESPIRATORY MEDICINE REVIEWS 2020. [DOI: 10.2174/1573398x15666191021122926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective:
To determine the effects of a pulmonary rehabilitation program in patients with
COPD who use and do not use supplemental oxygen during exercise.
Materials and Methods:
Prospective longitudinal descriptive study on 59 patients with COPD who
were part of a pulmonary rehabilitation program and who were classified into two groups: a group
that required supplemental oxygen during rehabilitation and another that did not.
Results:
31 patients were linked to the group that used oxygen during rehabilitation and 28 patients
who did not use it. The average age was 69.1 ± 10.6 years old. The mMRC dyspnea decreased 0.7 ±
0.2 (p = 0.000) in the group that used oxygen and 0.8 ± 0.1 (p = 0.000) in the group that did not use
it. The distance increased 45.9 meters ± 7.2 (p = 0.000) in the group that used oxygen and 65.2
meters ± 16.3 (p = 0.001) in the group that did not use it.
Conclusion:
Both groups showed significant improvements in dyspnea and aerobic capacity,
however, there was a greater increase in the group that did not use oxygen.
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Affiliation(s)
- Jhonatan Betancourt Peña
- Faculty of Health and Rehabilitation at Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia, School of Human Rehabilitation of the Faculty of Health at Universidad del Valle, Cali, Colombia
| | - Juan Carlos Ávila Valencia
- Faculty of Health and Rehabilitation at Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia, Universidad Santiago de Cali (Cali, Colombia). Clínica de Occidente S.A, Cali, Colombia
| | | | - Hugo Hurtado Gutiérrez
- Msc Public Health. Msc Biostatistics, Faculty of Health at Universidad del Valle, Cali, Colombia
| | - Vicente Benavides Córdoba
- Faculty of Health and Rehabilitation at Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia
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Hardavella G, Karampinis I, Frille A, Sreter K, Rousalova I. Oxygen devices and delivery systems. Breathe (Sheff) 2019; 15:e108-e116. [PMID: 31777573 PMCID: PMC6876135 DOI: 10.1183/20734735.0204-2019] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Oxygen use has extended from inpatient to outpatient settings for patients with chronic pulmonary diseases and complications of hypoxaemia. This article presents an overview of oxygen devices (oxygen concentrators, compressed gas cylinders and liquid oxygen) and delivery systems (high- and low-flow). The indications, advantages and disadvantages of each device and delivery system are presented, aiming to offer updated knowledge to the multidisciplinary team members managing patients with respiratory failure, and therefore allowing appropriate selection of devices and delivery systems that are tailored to the needs of each patient.
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Affiliation(s)
- Georgia Hardavella
- 10th Dept of Respiratory Medicine, Athens Chest Diseases Hospital "Sotiria", Athens, Greece
| | - Ioannis Karampinis
- Dept of Thoracic Surgery, General Hospital "Sismanogleio", Athens, Greece
| | - Armin Frille
- Dept of Respiratory Medicine, University of Leipzig, Leipzig, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Medical Center Leipzig, Leipzig, Germany
| | | | - Ilona Rousalova
- 1st Dept of Tuberculosis and Respiratory Diseases, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
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Mayoralas Alises S, Caneiras C, Díaz-Lobato S. A telephone-based survey of current trends, habits and beliefs in patients receiving portable oxygen therapy in Madrid, Spain. ERJ Open Res 2019; 5:00059-2018. [PMID: 31123685 PMCID: PMC6526202 DOI: 10.1183/23120541.00059-2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 03/23/2019] [Indexed: 01/23/2023] Open
Abstract
Portable oxygen therapy is a major challenge for patients and clinicians. Additionally, the available evidence on this subject is poor considering that only a few studies have been published and the results have not been encouraging. We explored the current trends, habits and beliefs among patients receiving portable oxygen therapy in a geographical area of Madrid, Spain (4 051 862 inhabitants). A telephone-based survey was conducted among patients selected from a database who were undergoing portable oxygen therapy. The number of patients on home respiratory therapies on December 31, 2017 was 81 559 (prevalence 2013.30 per 100 000 inhabitants). A total of 19 492 patients were on home oxygen therapy (HOT) (prevalence 481.16 per 100 000 inhabitants). Of these, 4015 patients (20% of the total of patients on HOT) received ambulatory oxygen therapy. In the analysed period, 1942 patients were selected (57.31% male and 42.69% female). The mean±sd age was 73.89±11.67 years. Most of patients had portable oxygen concentrators (99.59%). The survey was completed by 1777 patients. Most of patients thought they had been prescribed HOT for respiratory failure. 55% of the participants surveyed reported having carried out a walking test with oxygen to know the amount of oxygen they needed. 71% of the participants reported leaving the home for between 1 and 3 h a day. Most of them were carrying portable devices in a wheeled cart (51.94%). Our study data obtained from a large sample of oxygen-dependent individuals provide valuable information regarding domiciliary and portable oxygen usage in Madrid. A telephone survey was conducted in patients undergoing portable oxygen therapy. Data from a large sample of patients show us that they have a good training in ambulatory oxygen use.http://bit.ly/2Z6mP94
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Affiliation(s)
- Sagrario Mayoralas Alises
- Pneumological Dept, Moncloa University Hospital, Madrid, Spain.,Universidad Europea, Madrid, Spain.,Medical Division, Praxair Iberia, Madrid, Spain
| | - Catia Caneiras
- Medical Division, Praxair Portugal, Lisbon, Portugal.,Institute of Enviromental Health (ISAMB), Faculty of Medicine, University of Lisboa, Lisbon, Portugal
| | - Salvador Díaz-Lobato
- Pneumological Dept, Ramón y Cajal University Hospital, Institute Ramón y Cajal for Health Research (IRYCIS), Alcalá de Henares University, Madrid, Spain
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Lourido-Cebreiro T, González-Barcala FJ, Álvarez-Dobaño JM, Pereiro-Brea T, Abelleira-Paris R, Valdés L. Need for Portable Oxygen Titration During 6-Minute Walk Tests. Arch Bronconeumol 2019; 55:539-540. [PMID: 30981552 DOI: 10.1016/j.arbres.2019.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 02/10/2019] [Accepted: 03/07/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Tamara Lourido-Cebreiro
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España.
| | - Francisco J González-Barcala
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - José Manuel Álvarez-Dobaño
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Tara Pereiro-Brea
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España
| | - Romina Abelleira-Paris
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
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Barrueco-Otero E, Bartol Sánchez M, Pérez Rodríguez J, González Ruiz JM, Barrueco Ferrero M. Adherence to Long-Term Oxygen Therapy. Influence of Tobacco Use. Arch Bronconeumol 2019; 55:368-372. [PMID: 30713013 DOI: 10.1016/j.arbres.2018.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Domiciliary oxygen therapy (DOT) is a treatment that requires a high level of cooperation from patients due to the time it takes every day. A high level of non-compliance has been determined among patients receiving DOT. The aim of our study was to assess the level of non-compliance and the influence of active tobacco consumption on compliance. MATERIAL AND METHODS Patients were monitored in the home using direct and indirect methods, to assess both compliance and tobacco consumption. RESULTS The level of non-compliance detected by indirect methods was 22.6%, and 66.3% by direct methods. Tobacco consumption determined by indirect methods was 5.8%-8%, depending on the method used, and 16.2% when CO in exhaled air ≥10ppm was established as an indicator of tobacco use. The group of smokers complied with oxygen therapy for a significantly fewer number of hours per day (P<.001) than non-smokers. CONCLUSIONS There is a high level of therapeutic non-compliance and a significant percentage of patients receiving DOT continue to smoke. Compliance must be monitored, and the correct use of DOT must be emphasized. Additional efforts should also be made to help smokers with DOT to stop smoking, since continued smoking impacts negatively on therapeutic non-compliance.
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Affiliation(s)
- Enrique Barrueco-Otero
- Unidad Docente de Medicina Familiar y Comunitaria, Hospital de Barbastro, Huesca, España
| | | | | | - José María González Ruiz
- Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España; Departamento de Medicina, Universidad de Salamanca, Salamanca, España
| | - Miguel Barrueco Ferrero
- Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España; Departamento de Medicina, Universidad de Salamanca, Salamanca, España.
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