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Effect of Oxygen Therapy on Increasing Arterial Oxygen Tension in Hypoxemic Patients with Stable Chronic Obstructive Pulmonary Disease While Breathing Ambient Air (6)

One (25 percent) of four patients with PSa02 of 56 to 60 mm Hg at the beginning of the study demonstrated a Po2 greater than 60 mm Hg after one year. The data from these patients are presented in Tables 2 and 3.
Discussion
The total cost of home oxygen therapy in the United States is approximately $2 billion per year. For Medicare patients, this represents more than 45 percent of the cost of all durable medical equipment. A recent five-state survey of patients using home oxygen concentrators conducted by the Office of the Inspector General found that more than 30 percent of the patients surveyed were not using the concentrators at all or to the extent being billed when they had been prescribed at the time of discharge from a hospital. Up to the present time, the Health Care Financing Administration (HCFA) Guidelines for Reimbursement of Home Oxygen Therapy specifically request ABG measurements done in the hospital as preferred documentation of the need for LTOT. With encouragement for early discharge from the hospital brought about by the prospective payment system, many patients leave the hospital while still recovering from an acute exacerbation of respiratory disease and need short-term oxygen therapy (STOT) to correct transient hypoxemia.

Table 2—Patents Receiving Long-term Oxygen Therapy with FaO% <55 mm Hg When Oxygen Therapy Was Initiated

PatientNo. Po, T„ mm Hg Po, T„ mm Hg Pco2 T„ mm Hg Pco2 Ta, mm Hg APpa T.-T., mm Hg
Croup A
1 48 56 45.5 38.5 -3.52
2 54 58 43 47 -3.00
3 43 66.5 60.5 55.5 -6.0
Croup B
4 53 51 47.5 58 + 4.4
5 48.5 49 58 53.5 -13.0
6 42 44 48 51.5 +0.67
7 49 50 48 47 -1.94
8 51 37 61 58.5 -0.24
9 36.5 37 55.5 66 -9.00
10 42 53 46.5 37 -0.33
11 51 52 42.5 37 -1.17
12 52.5 39.5 46.5 56 +4.4

Table 3—Patients Receiving Long-term Oxygen Therapy with FaOt 56 to 59 mm Hg When Oxygen Therapy ms Initiated

PatientNo. Poa T1# mm Hg POa Ta, mm Hg PcOj T„ mm Hg PcOa Ta, mm Hg APpa TrTa, mm Hg
Group A
1 58 62 52 58.5 +0.11
Croup B
2 57 46.5 48 43.5 -0.19
3 58 48 61 52 -1.54
4 59 52 52 51 1.00

Category: Pulmonary disease

Tags: hypoxemia, oxygen therapy, pulmonary hypertension

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