Stéphane Bourassa1,2,3, Pierre-Alexandre Bouchard1, Marc Dauphin4,5, François Lellouche6. 1. Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, Québec, Canada. 2. PhD Candidate in Experimental Medicine, Montréal University, Faculty of Medicine, Montréal, Canada. 3. Retired Officer of the Canadian Armed Forces Intelligence Services. 4. Retired Officer of the Royal Canadian Medical Service. 5. Former Commanding Officer of NATO Role 3 Afghanistan in 2009, NATO Multi-National Kandahar Hospital. 6. Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, Québec, Canada. francois.lellouche@criucpq.ulaval.ca.
Abstract
BACKGROUND: Oxygen titration is recommended to avoid hyperoxemia and hypoxemia. Automated titration, as well as the [Formula: see text] target, may have an impact on oxygen utilization, with potential logistical effects in emergency and military transportation. We sought to assess the oxygen flow required for different [Formula: see text] targets in spontaneously breathing subjects, and to evaluate individualized automated oxygen titration to maintain stable oxygenation in subjects with COPD and healthy subjects with induced hypoxemia. METHODS: In the first part of the study, oxygen flow was evaluated in hospitalized subjects for different [Formula: see text] targets from 90% to 98%. Oxygen requirements to reach these targets were determined using a device that automatically adjusts oxygen flow every second on the basis of the [Formula: see text] target. In the second part of the study, the same automated oxygen titration method was used to correct hypoxemia in subjects with COPD and in healthy subjects with induced hypoxemia while the subjects wore a gas mask. Oxygen flow, [Formula: see text], and heart rate were continuously recorded. RESULTS: Thirty-six spontaneously breathing hospitalized subjects were included in the first part of the study. Oxygen flow was reduced more than 6-fold when the [Formula: see text] target was decreased from 98% to 90%. The second part of the study included 15 healthy and 9 subjects with stable COPD. In healthy subjects, heterogeneous oxygen flows were required to correct induced hypoxemia (0.2-2.5 L/min). In subjects with COPD, oxygen flow varied from 0 L/min (in 9 of 18 tested conditions) to 2.9 L/min. CONCLUSIONS: Significant reductions in the amount of oxygen delivered could be obtained with optimized [Formula: see text] targets. Oxygen delivery through a gas mask to correct hypoxemia is feasible, and automated oxygen titration may help individualize oxygen administration and reduce oxygen utilization. (ClinicalTrials.gov registration: NCT02782936, NCT02809807.).
BACKGROUND:Oxygen titration is recommended to avoid hyperoxemia and hypoxemia. Automated titration, as well as the [Formula: see text] target, may have an impact on oxygen utilization, with potential logistical effects in emergency and military transportation. We sought to assess the oxygen flow required for different [Formula: see text] targets in spontaneously breathing subjects, and to evaluate individualized automated oxygen titration to maintain stable oxygenation in subjects with COPD and healthy subjects with induced hypoxemia. METHODS: In the first part of the study, oxygen flow was evaluated in hospitalized subjects for different [Formula: see text] targets from 90% to 98%. Oxygen requirements to reach these targets were determined using a device that automatically adjusts oxygen flow every second on the basis of the [Formula: see text] target. In the second part of the study, the same automated oxygen titration method was used to correct hypoxemia in subjects with COPD and in healthy subjects with induced hypoxemia while the subjects wore a gas mask. Oxygen flow, [Formula: see text], and heart rate were continuously recorded. RESULTS: Thirty-six spontaneously breathing hospitalized subjects were included in the first part of the study. Oxygen flow was reduced more than 6-fold when the [Formula: see text] target was decreased from 98% to 90%. The second part of the study included 15 healthy and 9 subjects with stable COPD. In healthy subjects, heterogeneous oxygen flows were required to correct induced hypoxemia (0.2-2.5 L/min). In subjects with COPD, oxygen flow varied from 0 L/min (in 9 of 18 tested conditions) to 2.9 L/min. CONCLUSIONS: Significant reductions in the amount of oxygen delivered could be obtained with optimized [Formula: see text] targets. Oxygen delivery through a gas mask to correct hypoxemia is feasible, and automated oxygen titration may help individualize oxygen administration and reduce oxygen utilization. (ClinicalTrials.gov registration: NCT02782936, NCT02809807.).
Authors: Ekin Soydan; Gokhan Ceylan; Sevgi Topal; Pinar Hepduman; Gulhan Atakul; Mustafa Colak; Ozlem Sandal; Ferhat Sari; Utku Karaarslan; Dominik Novotni; Marcus J Schultz; Hasan Agin Journal: Front Med (Lausanne) Date: 2022-08-25
Authors: Stephane Bourassa; Emmanuelle Paquette-Raynard; Daniel Noebert; Marc Dauphin; Pelumi Samuel Akinola; Jason Marseilles; Philippe Jouvet; Jacinthe Leclerc Journal: Prehosp Disaster Med Date: 2022-03-11 Impact factor: 2.040