AUTOMATIC OXYGEN TITRATION AS A TOOL IN INPATIENT PULMONARY REHABILITATION: REAL-WORLD PRACTICE EXPERIENCE
本文通过四个住院COPD患者的病例，描述了自动氧滴定系统在肺康复运动中的临床应用，发现其能减少手动调整、提高氧合稳定性和安全性，对康复团队和患者均有帮助。
Introduction: Inpatient Pulmonary Rehabilitation is often limited by exertional desaturation and variable oxygen requirements during activities. Manual oxygen titration is frequently reactive, making adaptation to different levels of effort challenging and increasing the workload of the healthcare team and potentially desaturation occurs without identification. Materials and Methods: Our goal was describe the clinical utility of the automatic oxygen titration - O2matic ® - system during exercise and breathing techniques sessions in the inpatient setting. This case series was based on clinical records of hospitalized chronic respiratory disease patients with respiratory failure requiring oxygen therapy. Representative cases in which O2matic® was used during exercise, ambulation and breathing techniques sessions, were described. Evaluation was based on clinical observation and clinical records and about team’s perception of the system’s usefulness. Results: Four hospitalized COPD patients were included (two female, minimum 44 and maximum 76 years). All had respiratory failure with exertional desaturation. The predefined target SpO2 range was 88–92%, with baseline oxygen flow rates at rest ranging from 2 to 8 L/min. The system allowed automatic and continuous oxygen flow adjustment in response to activity intensity. Programmed maximum flow ranged from 6 to 15 L/min. The maximum oxygen flow reached during exertion from 5 to 8 L/min. Desaturation below 88% was observed in only one case, without requiring interruption of the sessions, with no safety issues reported. The multidisciplinary team reported increased safety, reduced need for manual oxygen adjustments, and enablement of continuous functional training. Also improved subjective exercise tolerance, support in assessing oxygen requirements, and improved adaptation to high oxygen flow demands during exertion. Conclusions: In real-world, automatic oxygen titration promised to be a potential useful tool to support inpatient pulmonary rehabilitation, with greater oxygenation stability, less manual adjustments, higher perceived safety for both patients and professionals and also helping in a safety oxygen weaning.