Effekte einer Sauerstoffsonde mit Reservoir (Oxymizer) im Vergleich zu einer konventionellen Sauerstoffbrille bei Patienten mit COPD, Stadium III und IV unter körperlicher Belastung
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Philipps-Universität Marburg
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Abstract
,,The Oxymizer® is a special oxygen cannula that provides a higher luminal
diameter in combination with an incorporated oxygen reservoir‘‘ [Gloeckl et al,
2014]. So far, the impact of an Oxymizer® on performance and oxygenation of
patients with severe chronic obstructive pulmonary disease is little explored.
Therefore the aim of this study was to close this gap in existing research by
investigating the effects of the Oxymizer® on endurance time in comparison to
a conventional nasal cannula (CNC). During a three week pulmonary
rehabilitation forty three patients with severe chronic obstructive pulmonary
disease (age=60,1±8,9 a, FEV1=35,7 (23,1; 47,1) %pred,
DLCO=29±13,7 %pred) and indication for LTOT performed four cycling
endurance time tests at 70 % of their peak work rate in addition to the actual
pulmonary rehabilitation program. Endurance tests were performed twice with
Oxymizer® and with a CNC while reversing the treatment order after one week.
During the measurement of the endurance time SpO2, tcpCO2 and pulse
frequency were monitored using a SenTec Digital Monitoring System (SDMS).
This system noninvasively and continuously records the ventilation (tcpCO2),
the oxygen supply (SpO2) and the pulse frequency in real time in a clinical
environment. Additionally, before and after the endurance time tests a capillary
blood sample was taken for blood gas analysis. Furthermore, capillary blood
samples were taken for blood gas analysis during rest to enable a complete
comparison of the Oxymizer® to a conventional nasal cannula. Using these
samples it was investigated whether the O2 flow rate could be lowered under
the application of the Oxymizer® while achieving equal blood gas results. The
results show that the endurance time was significantly higher when patients
cycled while using the Oxymizer® in comparison to cycling while using the CNC
(Oxymizer® 575 (330; 1278,5) seconds versus CNC
644 (281; 1053,5) seconds; p=0,004) [Gloeckl et al, 2014]. The difference
between the two groups was 91,3±194,8 seconds. Furthermore, at the end of
the endurance time the oxygen partial pressure was significantly higher when
using the Oxymizer® (64,8±11,4 mmHg versus 61,5±10 mmHg; p<0,001) at
comparable carbon dioxide partial pressure (45,1 (36,5; 53,4) mmHg versus
43 (37,3; 53,5) mmHg; p=0,405). However at the end of the endurance time the
subjective perceived dyspnea and leg fatigue between both oxygen applications
were similar (Oxymizer® Borg dyspnea 7 (5,5; 8), Borg leg fatigue 6,5 (5; 8,5)
versus conventional nasal cannula Borg dyspnea 7,5 (5,9; 8), Borg leg fatigue
7 (5,5; 8); p=0,304 und p=0,243). Nevertheless overall results reveal a positive
correlation between improvements in endurance time and O2 flow rate (CNC
ρ=0,248, p=0,109, Oxymizer® ρ=0,348, p=0,022). A difference between the
improvements in the constant work rate test between patients with a lower
demand for O2 (2-3 liters/ min) and patients with a higher demand for O2 (4-
6 liters/ min) was shown. Patients with a higher demand for O2 (4-6 liters/ min)
were able to improve endurance time significantly more (p=0,009) than patients
with a lower demand for O2 (2-3 liters/ min) (161,2±225,4 seconds versus
18,1±123,9 seconds). On equal terms during resting periods paO2 with
Oxymizer® showed a significant superiority to CNC (76,9±11,6 mmHg versus
73,8±10,3 mmHg, p=0,009). But as soon as the flow rate with Oxymizer® was
decreased, the observed effect disappeared. On the contrary the Oxymizer®
now was significantly inferior to the utilization of CNC (x-1l O2 with Oxymizer®
p=0,003, x-2l O2 with Oxymizer® p<0,001). The collected data of the
endurance time indicates that O2 delivery via the Oxymizer® is superior to a
CNC with regard to endurance capacity and oxygenation during exercise for
patients with severe COPD. Especially patients with a higher demand for O2
(≥4 liters/ min) could achieve a clinical relevant benefit [Gloeckl et al, 2014]. But
the findings during resting periods demonstrate that even under the application
of the Oxymizer® the O2 flow rate cannot be lowered to achieve equal blood
gas results. Nevertheless the Oxymizer® is superior to CNC when compared
under an identical flow rate.
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Created: 2018Issued: 2018-05-03Updated: 2018-05-03
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
hypoxemic COPD patientsOxymizerEndurance Time
DFG-subjects
COPD III und IVEndurance TimeOxymizer
DDC-Numbers
610
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Matthaei, Alexander Maximilian: Effekte einer Sauerstoffsonde mit Reservoir (Oxymizer) im Vergleich zu einer konventionellen Sauerstoffbrille bei Patienten mit COPD, Stadium III und IV unter körperlicher Belastung. : Philipps-Universität Marburg 2018-05-03. DOI: https://doi.org/10.17192/z2018.0204.