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Academic Department
of Respiratory Medicine, St Bartholomew's and Royal London School of
Medicine and Dentistry, London Chest Hospital, Bonner Road, London E2
9JX, UK
Correspondence to: Dr J A Wedzicha.
Received 7 September 1998; Returned to authors 15 October 1998; Revised version received 12 November 1998; Accepted for publication 17 November 1998
BACKGROUND
Oxygen
conserving devices may lead to substantial increases in the duration of
oxygen provided. A study was undertaken to compare the performance of a
pulsed dose oxygen delivery (PDOD) system with continuous flow oxygen
or air during a maximal walking test.
METHODSFourteen
patients with chronic obstructive pulmonary disease (COPD) and arterial
oxygen desaturation on exercise (mean (SD) forced expiratory volume in
one second (FEV1) 0.83 (0.28) l, arterial oxygen pressure
(PaO2) 8.38 (1.24) kPa, arterial carbon
dioxide pressure (PaCO2) 5.95 (0.86) kPa) were
randomised to perform a walking test using air administered via a
cylinder or continuous flow oxygen at 2 l/min or by a PDOD system.
RESULTSThere
was no significant difference in the mean arterial oxygen saturation
(SaO2) using the PDOD system or with continuous flow oxygen (p = 0.33). Patients showed greatest desaturation whilst
walking with the air cylinder (SaO2 79.2 (8.59)%) which was significantly different from the desaturation with
both continuous flow oxygen (87.6 (5.85)%, p = 0.001) and PDOD (85.6 (7.36)%, p = 0.004). There was no significant difference between the
distance walked using oxygen delivered at 2 l/min by continuous flow
or via the PDOD (p = 0.72; CI 0.34 to 1.08). The mean (SD) distance walked on continuous flow oxygen (203.6 (106.1) m) and PDOD (207.9 (109.8) m) was significantly greater than the distance walked with the
air cylinder (188.6 (110.02) m); (1.12 fold increase in distance, CI
1.01 to 1.23, p = 0.02, and 1.14 fold increase in distance, CI 1.01 to
1.28, p = 0.03, respectively).
CONCLUSIONSThese
findings suggest that the pulsed dose oxygen conserving device was as
effective as continuous flow oxygen in maintaining arterial oxygen
saturation and that the use of this device was associated with similar
improvements in exercise tolerance to patients taking continuous flow
oxygen therapy.
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