The Efficiency of Long Term Oxygen Therapy in COPD

Abstract

oBJeCTIVe: The effects of long term oxygen therapy (LTOT) on the quality of life and survival of chronic obstructive pulmonary disease (COPD) patients with respiratory failure, and the compliance to LTOT were investigated in this prospective cohort study. MATerIAL ANd MeTHods:Fifty-four COPD patients, in whom LTOT was indicated, were recruited to the study between February 2006 and July 2007. Patients received two follow-up visits at 5 and 10 months, and were followed for approximately 19 months. Echocardiography was performed and the dyspnoea score (Medical Research Council, MRC) and St. George Respiratory Questionnaire (SGRQ) were applied at the initial and follow-up visits. In addition, the duration of oxygen treatment and indication for maintenance of LTOT was evaluated.resULTs: The mean age of the patients was 64 years; 7 were female and 47 were male. The mean duration of oxygen treatment prior to the first and second follow-up visits were 9.8 and 10.6 hours, respectively. The percentage of effective LTOT use (15 hours or more) at the first and second follow-up visits was 31% and 46%, respectively. There was no statistically significant difference in the survival of patients who were using effective and ineffective oxygen treatment. The mean baseline pulmonary arterial pressure showed a significant decrease from 50 mmHg at baseline to 40mmHg at the second follow-up visit in patients using effective LTOT (p=0.01). The symptom scores of SGRQ at the second follow-up visit were higher than the baseline values (p=0.005). CoNCLUsIoN:In the present study, patient compliance to LTOT was low. Although there was a decrease in pulmonary artery pressure, and an improvement in the life quality of patients as a result of LTOT use, LTOT had no effect on the survival of patients.Key words: COPD, long term oxygen therapy, survival, pulmonary hypertension INTrodUCTIoNChronic Obstructive Pulmonary disease (COPD) is an increasing cause of significant morbidity and mortality, worldwide. It is the fourth leading cause of death in the world and along with the increase in smoking, is expected to rise to the third leading cause of death in 2020. Similar to the other countries in the world, COPD is becoming an important problem in Turkey. Long-term oxygen treatment (LTOT) reverses secondary polycythemia due to hypoxemia, decreases pulmonary hypertension, improves right heart failure and strengthens cardiac functions. In addition, it increases effort capacity, improves quality of life and prolongs survival [1,2].In this present study, COPD patients having respiratory failure in whom LTOT was indicated were informed in details about the benefits, use and the problems that may arise because of misuse of LTOT, and were scheduled for follow-up. Our aim was to evaluate the compliance to the long-term oxygen therapy, to determine whether indication for LTOT maintained in patient follow-ups, to examine the effects of LTOT to physiological parameters, and to evaluate the effects on the quality of life and survival. Slightly different from th...