Escola Paulista de Medicina, Universidade de São Paulo, São Paulo, Brazil.
J Pediatr (Rio J). 2011 Jan-Feb;87(1):13-8. doi: 10.2223/JPED.2050. Epub 2010 Dec 21.
To describe the clinical and laboratory characteristics of patients on long-term home oxygen therapy followed up by the home care program of Hospital das Clínicas, School of Medicine, Universidade de São Paulo, during a period of 8 years; to compare groups with and without secondary pulmonary hypertension; and to estimate the cost of the program using oxygen concentrators vs. oxygen cylinders provided by the hospital.
A descriptive, retrospective cohort study of patients on long-term home oxygen therapy followed up from 2002 to 2009 at the Unit of Pulmonology, Children's Institute, Hospital das Clínicas, School of Medicine, Universidade de São Paulo.
We studied 165 patients, of whom 53% were male, with the following medians: age at the beginning of oxygen therapy--3.6 years; duration of oxygen therapy--7 years; and survival time after beginning of oxygen therapy--3.4 years. The main diagnoses were: cystic fibrosis (22%), bronchopulmonary dysplasia (19%), and bronchiolitis obliterans (15%). Of the 33 patients who underwent spirometry, 70% had severe obstructive lung disease. Echocardiogram was performed in 134 patients; 51% of them had secondary pulmonary hypertension. There was a statistically significant association between pulmonary hypertension and need of higher oxygen flows (chi-square, p = 0.011), and between pulmonary hypertension and longer duration of oxygen therapy (Logrank, p = 0.0001). There was no statistically significant difference between survival time after the beginning of oxygen therapy and pulmonary hypertension. The average monthly costs of the program were US$ 7,392.93 for concentrators and US$ 16,630.92 for cylinders.
Long-term home oxygen therapy was used to treat different chronic diseases, predominantly in infants and preschool children. There was a high frequency of pulmonary hypertension associated with longer periods of oxygen use and greater oxygen flow, without association with survival rate. The use of concentrators instead of cylinders may reduce costs significantly.
描述在圣保罗大学医学院附属医院临床诊所接受家庭护理计划的长期家庭氧疗患者的临床和实验室特征；比较伴有和不伴有继发性肺动脉高压的组；并使用医院提供的氧气浓缩器与氧气罐来估计该计划的成本。
这是一项针对 2002 年至 2009 年在圣保罗大学医学院附属医院儿科学肺科门诊接受长期家庭氧疗的患者的描述性、回顾性队列研究。
我们研究了 165 名患者，其中 53%为男性，中位数为：开始氧疗时的年龄为 3.6 岁；氧疗持续时间为 7 年；开始氧疗后的生存时间为 3.4 年。主要诊断为：囊性纤维化（22%）、支气管肺发育不良（19%）和闭塞性细支气管炎（15%）。在进行肺功能检查的 33 名患者中，70%有严重阻塞性肺病。对 134 名患者进行了超声心动图检查；其中 51%患有继发性肺动脉高压。肺动脉高压与更高的氧气流量需求之间存在统计学显著关联（卡方，p=0.011），与氧疗持续时间较长之间存在统计学显著关联（对数秩检验，p=0.0001）。在开始氧疗后的生存时间与肺动脉高压之间没有统计学显著差异。该计划的每月平均成本为浓缩器 7392.93 美元，罐式 16630.92 美元。
长期家庭氧疗用于治疗不同的慢性疾病，主要是在婴儿和学龄前儿童中。继发性肺动脉高压的发生率很高，与较长的氧气使用时间和更大的氧气流量有关，与生存率无关。与使用罐式相比，使用浓缩器可显著降低成本。
