Improving Home Oxygen Therapy in Patients with Interstitial Lung Diseases (ILDS): Application of a Portable Non-Invasive Ventilation (NIV) Device

Abstract

Background: Proper adjustment of arterial oxygen saturation (SaO2) during daily activities in interstitial lung disease (ILD) patients requiring long-term oxygen therapy (LTOT) is challenging. Given the multifactorial nature of the limited exercise tolerance in patients with ILDs, the isolated use of oxygen therapy may not be enough. As demonstrated previously in COPD patients, the use of a portable non-invasive ventilation (NIV) device combined with oxygen therapy may prevent the falling of oxygen saturation during exercise, due to an increased activation of respiratory muscles that could lead to an improvement of exercise tolerance. We sought to assess in patients diagnosed with ILD who are in need of oxygen therapy, the effect of associating a portable NIV to improve oxygen parameters and the distance covered during the 6 minutes walking test (6MWT).Methods: We conducted a prospective observational study in patients with ILDs. After a clinical characterization, we performed 6MWT in two different situations: using a portable oxygen concentrator with the regular flow used by the patient during their daily life activities and afterwards adding the additional support of a NIV. The oxygen saturation parameters were registered with a portable oximeter. Results: We included 16 patients with different ILDs who have oxygen therapy prescribed. The use of NIV associated with oxygen therapy in comparison with the use of oxygen therapy alone showed an increase of the average SaO2 [91% (88-93) vs 88% (86-90); p=0.0005] and a decrease in the percentage of time with oxygen saturation<90% (CT90): 36% (6-56) vs 58% (36-77); p<0.0001. There were no changes in the 6MWT distance: 307m (222-419) vs 316m (228-425); p=0.10Conclusions: In our study the use of a portable NIV system associated with LTOT during exercise showed benefitial effects, especially improvement of oxygen saturation.