Magnitude of Usage and Cost of Home Oxygen Therapy in the United States

OʼDonohue, Walter J.; Plummer, Alan L.

doi:10.1378/chest.107.2.301

Cited by 56 publications

(29 citation statements)

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“…Bacterial counts in the lungs of AA-treated mice were significantly less than that of saline-treated mice (0. 4 Figure 1A). Similar results were obtained in the airways (1.5 6 0.6 3 10 7 versus 3.5 6 0.9 3 10 7 /ml BALF; t = 1.78, df = 41, P , 0.05; Figure 1B).…”

Section: Aa Significantly Increases Hyperoxiacompromised Bacterial CLmentioning

confidence: 98%

Ascorbic Acid Attenuates Hyperoxia-Compromised Host Defense against Pulmonary Bacterial Infection

Patel

Sampat

Espey

et al. 2016

Am J Respir Cell Mol Biol

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Supraphysiological concentrations of oxygen (hyperoxia) can compromise host defense and increase susceptibility to bacterial infections, causing ventilator-associated pneumonia. The phagocytic activity of macrophages is impaired by hyperoxia-induced increases in the levels of reactive oxygen species (ROS) and extracellular highmobility group box protein B1 (HMGB1). Ascorbic acid (AA), an essential nutrient and antioxidant, has been shown to be beneficial in various animal models of ROS-mediated diseases. The aim of this study was to determine whether AA could attenuate hyperoxiacompromised host defense and improve macrophage functions against bacterial infections. C57BL/6 male mice were exposed to hyperoxia (>98% O 2 , 48 h), followed by intratracheal inoculation with Pseudomonas aeruginosa, and simultaneous intraperitoneal administration of AA. AA (50 mg/kg) significantly improved bacterial clearance in the lungs and airways, and significantly reduced HMGB1 accumulation in the airways. The incubation of RAW 264.7 cells (a macrophage-like cell line) with AA (0-1,000 mM) before hyperoxic exposure (95% O 2 ) stabilized the phagocytic activity of macrophages in a concentration-dependent manner. The AA-enhanced macrophage function was associated with significantly decreased production of intracellular ROS and accumulation of extracellular HMGB1. These data suggest that AA supplementation can prevent or attenuate the development of ventilator-associated pneumonia in patients receiving oxygen support.

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Section: Aa Significantly Increases Hyperoxiacompromised Bacterial CLmentioning

confidence: 98%

Ascorbic Acid Attenuates Hyperoxia-Compromised Host Defense against Pulmonary Bacterial Infection

Patel

Sampat

Espey

et al. 2016

Am J Respir Cell Mol Biol

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“…Subsequently, patients have been widely prescribed LTOT on the basis of these studies. In 1995 it was reported that close to 800,000 patients (~280/100,000) in the USA were receiving LTOT at an annual cost of US$1.8 billion [3]. In France in 1996 17,500 patients were receiving LTOT in the ANTADIR network and an estimated similar number in the private sector (~70/100,000).…”

Section: Aamentioning

confidence: 99%

Characteristics and survival of patients prescribed long-term oxygen therapy outside prescription guidelines

Veale¹,

Chailleux²,

Taytard³

et al. 1998

Eur Respir J

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Criteria for the prescription of long-term oxygen therapy (LTOT) have been published by academic societies and regulatory bodies, but many prescriptions for LTOT do not fulfil these criteria. Demographic, functional data and survival were compared in chronic obstructive pulmonary disease (COPD) patients with different levels of oxygenation, i.e. arterial oxygen tension (Pa,O2) < 8 kPa or > or = 8 kPa (60 mmHg), at the time of initial registration in the ANTADIR Observatory. Data were collected between 1984-1995. Selection criteria were a diagnosis of COPD or emphysema with forced expiratory volume in one second (FEV1) < 80% pred, FEV1/vital capacity (VC) < 70% and age between 18-75 yrs. Of 7,700 patients prescribed LTOT 18.5% had stable Pa,O2 > or = 8 kPa. While the FEV1 was the same they differed from the patients with more severe hypoxaemia in having a higher rate of diagnosis of primary emphysema and a lower arterial carbon dioxide tension (Pa,CO2). In this group of patients LTOT was more frequently administered as liquid oxygen than in other patients on LTOT. The survival of these patients was reduced compared to the general population of the same age and sex but comparable to that of patients with a Pa,O2 between 6.7-8 kPa (50-60 mmHg). Patients prescribed long-term oxygen therapy with an arterial oxygen tension > or = 8 kPa (60 mmHg) in the ANTADIR network were shown to have severe chronic obstructive pulmonary disease on the basis of spirometry and their survival was similar to that of more hypoxaemic patients. Randomized controlled trials of the effect of long-term oxygen therapy in patients with arterial oxygen tension > or = 8 kPa are needed.

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“…Since the demonstration of a survival benefit of oxygen administration in patients with arterial hypoxemia and chronic obstructive pulmonary disease (COPD) was shown in the 1980s [1,2], it is estimated that over 600,000 patients with COPD receive this therapy [3]. Home oxygen therapy is the leading durable medical equipment expenditure for the Centers for Medicare and Medicaid Services (CMS), with estimated costs exceeding one billion dollars annually [3,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Home oxygen therapy is the leading durable medical equipment expenditure for the Centers for Medicare and Medicaid Services (CMS), with estimated costs exceeding one billion dollars annually [3,4,5]. However, it is often prescribed inappropriately (not meeting set criteria in up to 40.5% of patients) and with excessive flow rates based on suggested criteria [6].…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of the 6-Minute Walk Test for Ambulatory Oxygen Prescription

Chatterjee

Rissmiller²,

Meade³

et al. 2009

Respiration

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Background: Ambulatory oxygen is frequently prescribed for patients with chronic obstructive pulmonary disease (COPD) who have oxygen desaturation ≤88% during exercise. The 6-min walk test (6MWT) with continuous pulse oximetry monitoring is a common method to document this oxygen desaturation, but the reproducibility of this test in determining the need for ambulatory oxygen in patients with COPD is not well documented. Objective:The aim of this study was to establish the reproducibility of the 6MWT in determining the need for ambulatory oxygen prescription in stable COPD patients using the Centers for Medicare and Medicaid (CMS) criteria for ambulatory oxygen prescription. Methods:The study was designed as a prospective observational study in an academic health center and associated pulmonary rehabilitation program. Eighty-eight COPD patients referred to pulmonary rehabilitation underwent continuous pulse oximetry while performing standard 6MWT on 3 separate days. Results: Fifty-one (58%) of these patients desaturated by continuous pulse oximetry to an SpO₂ ≤88% on a least one of the 6MWTs. Only 26 patients (30%) demonstrated consistency in meeting the criteria for ambulatory oxygen set forth by the CMS on all three 6MWT with a κ statistic of 0.62. The percent agreement between 6MWTs for ambulatory oxygen prescription was 72% and the paired observation was 51%. Conclusions: The 6MWT distance is simple and widely used as a consistent measure of functional capacity in patients with COPD; however, the 6MWT oxygen saturation has only modest reproducibility in determining the need for ambulatory oxygen in stable COPD patients undergoing pulmonary rehabilitation.

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Magnitude of Usage and Cost of Home Oxygen Therapy in the United States

Cited by 56 publications

References 0 publications

Ascorbic Acid Attenuates Hyperoxia-Compromised Host Defense against Pulmonary Bacterial Infection

Ascorbic Acid Attenuates Hyperoxia-Compromised Host Defense against Pulmonary Bacterial Infection

Characteristics and survival of patients prescribed long-term oxygen therapy outside prescription guidelines

Reproducibility of the 6-Minute Walk Test for Ambulatory Oxygen Prescription

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