Shiner R J, Zaretsky U, Mirali M, Benzaray S, Elad D
Department of Clinical Respiratory Physiology, H. Sheba Medical Center, Tel Hashomer, Israel.
Isr J Med Sci. 1997 Jan;33(1):23-9.
Domiciliary long-term oxygen therapy (LTOT) is usually supplied by means of oxygen concentrators (OCs). Various factors that determine the efficacy of such a treatment were evaluated. Sixty-three patients, arbitrarily selected from lists of health care providers, were visited at home by a biomedical engineer and a pulmonary function technician. The evaluation consisted of: i) responses to a directed questionnaire, ii) assessment of the OC output characteristics, and iii) measurement of the patient's oxygen saturation (SaO2) at rest with and without oxygen supplement. Only 33% of patients received oxygen treatment for the recommended 12-24 hours/day and 5% of patients waited the recommended 10 minutes of OC warm-up before connection. Filters were cleaned weekly by only 30% of patients and the concentrator was serviced 3-4 times a year in 25% of cases. The OC was thought to be unduly noisy by 24% of patients and connecting tubing of less than 6 meters was fitted to 90% of OCs, thereby limiting patient mobility. Most of the OCs did not yield the recommended oxygen concentration and the flow rate meters on them tended to underread. Therefore, only 22% of patients received the prescribed oxygen supplement. Whilst breathing room air, a substantial proportion of patients had an SaO2 >90%. Improvements are clearly required in terms of medical indications for LTOT, patient education and supervision, supply and maintenance of concentrators and related equipment.
家庭长期氧疗（LTOT）通常通过制氧机（OC）来提供。对决定这种治疗效果的各种因素进行了评估。从医疗服务提供者名单中随机挑选了63名患者，由一名生物医学工程师和一名肺功能技术人员进行家访。评估包括：i）对定向问卷的回答，ii）对制氧机输出特性的评估，以及iii）在有和没有吸氧情况下测量患者静息时的血氧饱和度（SaO2）。只有33%的患者接受了推荐的每天12 - 24小时的氧疗，5%的患者在连接制氧机前等待了推荐的10分钟预热时间。只有30%的患者每周清洁过滤器，25%的情况下制氧机每年维修3 - 4次。24%的患者认为制氧机噪音过大，90%的制氧机配备了长度小于6米的连接管，从而限制了患者的活动能力。大多数制氧机没有达到推荐的氧浓度，并且其上的流量计往往读数偏低。因此，只有22%的患者接受了规定的吸氧。在呼吸室内空气时，相当一部分患者的SaO2 > 90%。在LTOT的医学指征、患者教育与监督、制氧机及相关设备的供应与维护方面显然需要改进。
