{"title":"Integrative Analyses of Mendelian Randomization and Transcriptomic Data Reveal No Association between Leptin and Chronic Obstructive Pulmonary Disease.","authors":"Ao Zhang, Suyan Tian","doi":"10.1080/15412555.2023.2260890","DOIUrl":"10.1080/15412555.2023.2260890","url":null,"abstract":"<p><p>As a key adipokine, leptin has been extensively investigated for its potential role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, concordant conclusions have not been attained. In this study, we investigated the relationship between leptin and COPD using an integrative analysis that combined a Mendelian randomization (MR) study with transcriptomic data analysis. Here, the MR analysis was performed on the online platform MR-Base, and the bioinformatics analyses were performed with the aid of R Bioconductor packages. No evidence was found by the integrative analysis to support the association of the two attributes. All methods detected a null causal effect of leptin on COPD in the MR analysis. In particular, when the genetically predicted leptin level increased one unit, the risk of developing COPD was estimated as 0.999 (<i>p</i> = 0.943), 0.920 (<i>p</i> = 0.516), 1.002 (<i>p</i> = 0.885), and 1.002 (<i>p</i> = 0.906) by the Inverse Variance Weighted (IVW), MR-Egger, weighted median, and weighted mode method, respectively. Furthermore, no leptin-associated genes except one were identified as being differentially expressed between COPD and control in bioinformatics analysis. The observed association between leptin and COPD in previous observational studies may be attributable to unmeasured confounding effects or reverse causation.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"20 1","pages":"321-326"},"PeriodicalIF":2.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41114783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paul Jones, Osamu Hataji, Yoshimi Suzukamo, Bruce Crawford, Yoko Sakai, Takeo Ishii, Keiko Sato, Eri Sasaki, Kenichi Hashimoto, Toru Oga
{"title":"Development of a Communication Tool between Patients and Physicians for Recognizing COPD Exacerbations in Japan.","authors":"Paul Jones, Osamu Hataji, Yoshimi Suzukamo, Bruce Crawford, Yoko Sakai, Takeo Ishii, Keiko Sato, Eri Sasaki, Kenichi Hashimoto, Toru Oga","doi":"10.1080/15412555.2023.2219742","DOIUrl":"10.1080/15412555.2023.2219742","url":null,"abstract":"<p><p>In Japan, exacerbations are underreported compared with other countries, possibly due in part to a failure to recognize them. This study aimed to create a simple chronic obstructive pulmonary disease (COPD) Exacerbation Recognition Tool (CERT-J) specifically for Japanese patients. Patients ≥40 years with confirmed COPD or asthma-COPD overlap were included. Focus groups were held to identify words and phrases used by patients to describe symptoms associated with an exacerbation, resulting in candidate items being identified. Following cognitive debriefing, the items were refined based on item frequency, level of endorsement and effect of demographic factors. Exploratory factor analysis (EFA) was then performed to inform an expert panel's choice of items to form the new tool. A total of 41 patients were included in the focus groups and nine patients performed the cognitive debrief. Following this, the expert panel identified 26 items for testing in a further 100 patients (mean age 72 years, forced expiratory volume in 1 s 54.8% predicted and 1.8 exacerbations in the preceding 12 months). Eleven items were associated with breathlessness or activity limitation and seven of these were the most frequently endorsed. EFA identified four factors, with one (breathlessness) being dominant. The expert panel recommended that the CERT-J should include six items: breathlessness and activity limitation (3 items), cough (1 item) and phlegm (2 items). The final CERT-J should benefit patients with COPD by providing them with an increased understanding and recognition of exacerbations.<b>Clinical Trial Registration:</b> GSK K.K (jRCT1080224526).</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"20 1","pages":"216-223"},"PeriodicalIF":2.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maksym Sharma, Paulina V Wyszkiewicz, Alexander M Matheson, David G McCormack, Grace Parraga
{"title":"Chest MRI and CT Predictors of 10-Year All-Cause Mortality in COPD.","authors":"Maksym Sharma, Paulina V Wyszkiewicz, Alexander M Matheson, David G McCormack, Grace Parraga","doi":"10.1080/15412555.2023.2259224","DOIUrl":"https://doi.org/10.1080/15412555.2023.2259224","url":null,"abstract":"<p><p>Pulmonary imaging measurements using magnetic resonance imaging (MRI) and computed tomography (CT) have the potential to deepen our understanding of chronic obstructive pulmonary disease (COPD) by measuring airway and parenchymal pathologic information that cannot be provided by spirometry. Currently, MRI and CT measurements are not included in mortality risk predictions, diagnosis, or COPD staging. We evaluated baseline pulmonary function, MRI and CT measurements alongside imaging texture-features to predict 10-year all-cause mortality in ex-smokers with (<i>n</i> = 93; 31 females; 70 ± 9years) and without (<i>n</i> = 69; 29 females, 69 ± 9years) COPD. CT airway and vessel measurements, helium-3 (<sup>3</sup>He) MRI ventilation defect percent (VDP) and apparent diffusion coefficients (ADC) were quantified. MRI and CT texture-features were extracted using PyRadiomics (version2.2.0). Associations between 10-year all-cause mortality and all clinical and imaging measurements were evaluated using multivariable regression model odds-ratios. Machine-learning predictive models for 10-year all-cause mortality were evaluated using area-under-receiver-operator-characteristic-curve (AUC), sensitivity and specificity analyses. DL<sub>CO</sub> (%<sub>pred</sub>) (HR = 0.955, 95%CI: 0.934-0.976, <i>p</i> < 0.001), MRI ADC (HR = 1.843, 95%CI: 1.260-2.871, <i>p</i> < 0.001), and CT informational-measure-of-correlation (HR = 3.546, 95% CI: 1.660-7.573, <i>p</i> = 0.001) were the strongest predictors of 10-year mortality. A machine-learning model trained on clinical, imaging, and imaging textures was the best predictive model (AUC = 0.82, sensitivity = 83%, specificity = 84%) and outperformed the solely clinical model (AUC = 0.76, sensitivity = 77%, specificity = 79%). In ex-smokers, regardless of COPD status, addition of CT and MR imaging texture measurements to clinical models provided unique prognostic information of mortality risk that can allow for better clinical management.<b>Clinical Trial Registration:</b> www.clinicaltrials.gov NCT02279329.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"20 1","pages":"307-320"},"PeriodicalIF":2.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41194095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuyan Zhou, Siqi He, Wanying Wang, Xiaoyue Wang, Xiaoting Chen, Xiaoning Bu, Deshuai Li
{"title":"Development and Validation of Prediction Models for Exacerbation, Frequent Exacerbations and Severe Exacerbations of Chronic Obstructive Pulmonary Disease: A Registry Study in North China.","authors":"Yuyan Zhou, Siqi He, Wanying Wang, Xiaoyue Wang, Xiaoting Chen, Xiaoning Bu, Deshuai Li","doi":"10.1080/15412555.2023.2263562","DOIUrl":"10.1080/15412555.2023.2263562","url":null,"abstract":"<p><p>In COPD patients, exacerbation has a detrimental influence on the quality of life, disease progression and socioeconomic burden. This study aimed to develop and validate models to predict exacerbation, frequent exacerbations and severe exacerbations in COPD patients. We conducted an observational prospective multicenter study. Clinical data of all outpatients with stable COPD were collected from Beijing Chaoyang Hospital and Beijing Renhe Hospital between January 2018 and December 2019. Patients were followed up for 1 year. The data from Chaoyang Hospital was used for modeling dataset, and that of Renhe Hospital was used for external validation dataset. The final dataset included 456 patients, with 326 patients as the model group and 130 patients as the validation group. Using LABA + ICS, frequent exacerbations in the past year and CAT score were independent risk factors for exacerbation in the next year (OR = 2.307, 2.722 and 1.147), and FVC %pred as a protective factor (OR = 0.975). Combined with chronic heart failure, frequent exacerbations in the past year, blood EOS counts and CAT score were independent risk factors for frequent exacerbations in the next year (OR = 4.818, 2.602, 1.015 and 1.342). Using LABA + ICS, combined with chronic heart failure, frequent exacerbations in the past year and CAT score were independent risk factors for severe exacerbations in the next year (OR = 1.950, 3.135, 2.980 and 1.133). Based on these prognostic models, nomograms were generated. The prediction models were simple and useful tools for predicting the risk of exacerbation, frequent exacerbations and severe exacerbations of COPD patients in North China.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"20 1","pages":"327-337"},"PeriodicalIF":2.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49689116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Triple Inhaler versus Dual Bronchodilator Therapy in COPD: Real-World Effectiveness on Mortality.","authors":"Samy Suissa, Sophie Dell'Aniello, Pierre Ernst","doi":"10.1080/15412555.2021.1977789","DOIUrl":"https://doi.org/10.1080/15412555.2021.1977789","url":null,"abstract":"<p><p>Randomized trials of triple therapy including an inhaled corticosteroid (ICS) for chronic obstructive pulmonary disease (COPD) reported remarkable benefits on mortality compared with dual bronchodilators, likely resulting from ICS withdrawal at randomization. We compared triple therapy with dual bronchodilator combinations on major COPD outcomes in a real-world clinical practice setting. We identified a cohort of COPD patients, age 50 or older, treated during 2002-2018, from the United Kingdom's Clinical Practice Research Datalink. Patients initiating treatment with a long-acting muscarinic antagonist (LAMA), a long-acting beta<sub>2</sub>-agonist (LABA) and an ICS on the same day, were compared with patients initiating a LAMA and LABA, weighted by fine stratification of propensity scores. Subjects were followed-up one year for all-cause mortality, severe exacerbation and pneumonia. The cohort included 117,729 new-users of LAMA-LABA-ICS and 26,666 of LAMA-LABA. The adjusted hazard ratio (HR) of all-cause mortality with LAMA-LABA-ICS compared with LAMA-LABA was 1.17 (95% CI: 1.04-1.31) while for severe exacerbation and pneumonia it was 1.19 (1.08-1.32) and 1.29 (1.16-1.45) respectively. However, mortality was not elevated with triple therapy among patients with asthma diagnosis (HR 0.99; 95% CI: 0.74-1.34), with two or more prior exacerbations (HR 0.88; 95% CI: 0.70-1.11), and with FEV<sub>1</sub> percent predicted >30%. In a real-world setting of COPD treatment, triple therapy initiation was not more effective than dual bronchodilators at preventing all-cause mortality and severe COPD exacerbations. Triple therapy may be unsafe among patients without prior exacerbations, in whom ICS are not recommended, with no asthma diagnosis and with very severe airflow obstruction.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.1977789 .</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39434054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Gagatek, S R A Wijnant, B Ställberg, K Lisspers, G Brusselle, X Zhou, M Hasselgren, S Montgomeryi, J Sundhj, C Janson, Ö Emilsson, L Lahousse, A Malinovschi
{"title":"Validation of Clinical COPD Phenotypes for Prognosis of Long-Term Mortality in Swedish and Dutch Cohorts.","authors":"S Gagatek, S R A Wijnant, B Ställberg, K Lisspers, G Brusselle, X Zhou, M Hasselgren, S Montgomeryi, J Sundhj, C Janson, Ö Emilsson, L Lahousse, A Malinovschi","doi":"10.1080/15412555.2022.2039608","DOIUrl":"https://doi.org/10.1080/15412555.2022.2039608","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with variable mortality risk. The aim of our investigation was to validate a simple clinical algorithm for long-term mortality previously proposed by Burgel <i>et al.</i> in 2017. Subjects with COPD from two cohorts, the Swedish PRAXIS study (<i>n</i> = 784, mean age (standard deviation (SD)) 64.0 years (7.5), 42% males) and the Rotterdam Study (<i>n</i> = 735, mean age (SD) 72 years (9.2), 57% males), were included. Five clinical clusters were derived from baseline data on age, body mass index, dyspnoea grade, pulmonary function and comorbidity (cardiovascular disease/diabetes). Cox models were used to study associations with 9-year mortality. The distribution of clinical clusters (1-5) was 29%/45%/8%/6%/12% in the PRAXIS study and 23%/26%/36%/0%/15% in the Rotterdam Study. The cumulative proportion of deaths at the 9-year follow-up was highest in clusters 1 (65%) and 4 (72%), and lowest in cluster 5 (10%) in the PRAXIS study. In the Rotterdam Study, cluster 1 (44%) had the highest cumulative mortality and cluster 5 (5%) the lowest. Compared with cluster 5, the meta-analysed age- and sex-adjusted hazard ratio (95% confidence interval) for cluster 1 was 6.37 (3.94-10.32) and those for clusters 2 and 3 were 2.61 (1.58-4.32) and 3.06 (1.82-5.13), respectively. Burgel's clinical clusters can be used to predict long-term mortality risk. Clusters 1 and 4 are associated with the poorest prognosis, cluster 5 with the best prognosis and clusters 2 and 3 with intermediate prognosis in two independent cohorts from Sweden and the Netherlands.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":" ","pages":"330-338"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33449373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diêgo Mendes Xavier, Endi Lanza Galvão, Alenice Aliane Fonseca, Glaciele Maria de Souza, Vanessa Pereira Lima
{"title":"Effects of Home-Based Pulmonary Rehabilitation on Dyspnea, Exercise Capacity, Quality of Life and Impact of the Disease in COPD Patients: A Systematic Review.","authors":"Diêgo Mendes Xavier, Endi Lanza Galvão, Alenice Aliane Fonseca, Glaciele Maria de Souza, Vanessa Pereira Lima","doi":"10.1080/15412555.2021.2020234","DOIUrl":"https://doi.org/10.1080/15412555.2021.2020234","url":null,"abstract":"<p><p>Conventional pulmonary rehabilitation programs are used as therapies for the treatment of chronic obstructive pulmonary disease (COPD). However, this modality presents barriers that make rehabilitation difficult. For this reason, home-based pulmonary rehabilitation (HBPR) has been used to overcome these barriers. The objective was to systematically compare a structured program with HBPR or a control group for participants with COPD. The primary outcome was an improvement in symptoms in the level of dyspnea and secondary outcomes were parameters in lung function, exercise capacity, health-related quality of life (HRQoL) and the impact of the disease on the individual. The Medline (<i>via</i> PubMed), Virtual Health Library and Cochrane Library databases were searched until May 10, 2021. Randomized controlled trials were included without restrictions on the year of publication or language. The risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (RoB). Our results showed that there was a significant decrease in the level of dyspnea, (MD: 5.46; 95% CI: 1.97 to 8.96), increased distance covered (MD: 61.75; 95% CI: 42, 94 to 80.56, significant improvement in HRQoL (MD: -11.30; 95% CI: -19.81 to -2.79) and reduction in the impact of the disease (DM: -4.71; 95% CI: -7.95 to -1.47). All results found were comparing the intervention group versus the control group. To conclude we found a reduction in the levels of dyspnea, an increase in the distance covered on the six-minute walk test, improving HRQoL and decreasing the impact of the disease in COPD patients in home-based pulmonary rehabilitation.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":" ","pages":"18-46"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39797526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manuel Kuhn, Dario Kohlbrenner, Noriane A Sievi, Christian F Clarenbach
{"title":"Increasing Daily Physical Activity and Its Effects on QTc Time in Severe to Very Severe COPD: A Secondary Analysis of a Randomised Controlled Trial.","authors":"Manuel Kuhn, Dario Kohlbrenner, Noriane A Sievi, Christian F Clarenbach","doi":"10.1080/15412555.2022.2101992","DOIUrl":"https://doi.org/10.1080/15412555.2022.2101992","url":null,"abstract":"<p><p>Approximately, half of COPD patients die from cardiovascular diseases. A prolongation of cardiac repolarization (measured as QTc interval) is associated with cardiovascular events or cardiovascular deaths in populations of older adults and COPD. One way to reduce the QTc could be to increase physical activity (PA). We investigated whether QTc can be reduced by an increase in PA in patients with severe COPD. This is a secondary outcome analysis from a randomized controlled trial investigating the effects of a 3 months pedometer based program to improve PA. 12-lead ECG was assessed at baseline and after 3 months. We measured PA using a validated triaxial accelerometer. Data were analyzed from 59 participants. Multiple regression modeling, including adjustment for baseline QTc, sex, QT prolonging medications, BMI, smoking status and FEV1%, showed no evidence for an association between an improvement of ≥15% PA and QTc reduction. A 15% improvement in PA according to step counts over 3 months seems not to reduce QTc interval by its MCID of 20 ms in patients with severe to very severe COPD.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":" ","pages":"339-344"},"PeriodicalIF":2.2,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40375599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Colin Bartz-Overman, A. Albanese, V. Fan, E. Locke, T. Parikh, S. Thielke
{"title":"Potential Explanatory Factors for the Concurrent Experience of Dyspnea and Pain in Patients with COPD","authors":"Colin Bartz-Overman, A. Albanese, V. Fan, E. Locke, T. Parikh, S. Thielke","doi":"10.1080/15412555.2022.2081540","DOIUrl":"https://doi.org/10.1080/15412555.2022.2081540","url":null,"abstract":"Abstract Previous research has identified unexpectedly strong associations between dyspnea and pain, but the reasons remain unclear. Ascertaining the underlying biological and psychological mechanisms might enhance the understanding of the experience of both conditions, and suggest novel treatments. We sought to elucidate whether demographic factors, disease severity, psychological symptoms and biomarkers might account for the association between pain and dyspnea in individuals with COPD. We analyzed data from 301 patients with COPD who were followed in a prospective longitudinal observational study over 2 years. Measures included self-reported dyspnea and pain, pulmonary function tests, serum levels of inflammatory cytokines, measures of physical deconditioning, and scales for depression and anxiety. Analyses involved cross-sectional and longitudinal linear regression models. Pain and dyspnea were strongly correlated cross-sectionally (r = 0.77, 95% CI 0.72–0.82) and simultaneously across time (r = 0.42, 95% CI 0.28–0.56). Accounting for any of the other health factors only slightly mitigated the associations. Symptoms of pain and dyspnea thus may be fundamentally linked in COPD, rather than being mediated by common biological, psychological, or functional factors. From the patient’s perspective, pain and dyspnea may be part of the same essential experience. It is possible that treatments for one condition would improve the other.","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"33 1","pages":"282 - 289"},"PeriodicalIF":2.2,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80275688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An On-Demand Oxygen Flow Meter for Enhanced Patient Comfort and Reduced Oxygen Cost in Hospitals","authors":"E. Derom, E. Meijer, J. V. van Enschot","doi":"10.1080/15412555.2022.2078695","DOIUrl":"https://doi.org/10.1080/15412555.2022.2078695","url":null,"abstract":"Abstract Background: Hypoxemia is currently treated in hospital wards with oxygen, released continuously by “conventional” flow meters. A new type of hybrid flow meter allows to switch between on-demand and continuous mode. The aim of this observational study was to assess whether this new device reduces oxygen expenditure, is well accepted in a hospital setting and improves patient comfort during oxygen therapy. Methods: Oxygen was administered in hypoxemic patients with conventional or hybrid flow meters to maintain an oxygen saturation of ≥ 92% over a 12-week period. Every two weeks conventional and hybrid flow meters were switched. The overall oxygen delivery to the ward was continuously measured with a data logging device installed in the main oxygen pipeline and corrected for multiple confounding factors. Humidity measurements, for which a sensor placed in front of one of the nostrils, and patient questionnaires, were used to assess patient comfort during continuous and on-demand flow. Results: Overall oxygen delivery decreased by 39% when switching from continuous flow to on-demand therapy after correction for confounding factors. Continuous flows significantly decreased relative humidity more than equivalent on-demand settings and the latter tended to increase comfort. Conclusions: Hybrid flow meters cause a significant reduction in oxygen delivery in a hospital ward, which may lead to financial savings. Using the on-demand technology also lowers the dryness of the upper airways (and may increase patient comfort), while maintaining an adequate oxygenation.","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"30 1","pages":"274 - 281"},"PeriodicalIF":2.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88344010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}