Home Long-Term Oxygen Treatment in Italy

Negro, Roberto W. Dal; Goldberg, A.I.

doi:10.1007/88-470-0448-9

Cited by 4 publications

References 101 publications

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Changes in blood hemoglobin and blood gases PaO2 and PaCO2 in severe COPD overa three-year telemonitored program of long-term oxygen treatment

Negro

Tognella

Bonadiman³

et al. 2012

Multidiscip Respir Med

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BackgroundInformation on the effects of long-term oxygen treatment (LTOT) on blood hemoglobin (Hb) in severe COPD are limited. The aim was to assess blood Hb values in severe COPD, and investigate the time-course of both Hb and blood gas changes during a 3-year telemetric LTOT.MethodsA cohort of 132 severe COPD patients (94 males; 71.4 years ± 8.8 sd), newly admitted to the tele-LTOT program, was investigated. Subjects were divided according to their original blood Hb: group A: <13 g/dL; group B: ≥13 < 15 g/dL; group C: ≥ 5 < 16 g/dL; group D: ≥16 g/dL. Blood Hb (g/dL), PaO2 and PaCO2 (mmHg), SaO2 (%), and BMI were measured at LTOT admission (t0), and at least quarterly over three years (t1-t3). Wilcoxon test was used to compare t0 vs. t1 values; linear regression to assess a possible Hb-BMI relationship; ANOVA to compare changes in Hb time-courses over the 3 years.ResultsLTOT induced a systematic increase of PaO2, and changes were significant since the first year (from 52.1 mmHg ± 6.6sd to 65.1 mmHg ± 8.7 sd, p < 0.001). Changes in SaO2 were quite similar. Comparable and equally significant trends were seen in all subgroups (p < 0.001). PaCO2 dropped within the first year of LTOT (from 49.4 mmHg ± 9.1sd to 45.9 mmHg ±7.5 sd, p < 0.001): the t0-t1 comparison proved significant (p < 0.01) only in subgroups with the highest basal Hb, who showed a further PaCO2 decline over the remaining two years (p < 0.001). Hb tended to normalization during LTOT only in subgroups with basal Hb > 15 g/dl (ANOVA p < 0.001); anemic subjects (Hb < 13 g/dl) ameliorated not significantly in the same period (ANOVA = 0.5). Survival was independent of the original blood Hb. Anemia and polyglobulia are differently prevalent in COPD, the latter being the most represented in our cohort. LTOT affected both conditions, but to a different extent and according to different time-courses. The most striking Hb improvement was in polyglobulic patients in whom also PaO2, PaCO2 and SaO2 dramatically improved. In anemic subjects effects were smaller and slower, oxygenation being equally ameliorated by LTOT.ConclusionsLTOT effects on Hb and PaCO2 are regulated by an Hb-dependent gradient which seems independent of the original impairment of blood gases and of effects on oxygenation.

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Changes in blood hemoglobin and blood gases PaO2 and PaCO2 in severe COPD overa three-year telemonitored program of long-term oxygen treatment

Negro

Tognella

Bonadiman³

et al. 2012

Multidiscip Respir Med

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A Low-Cost Breath Analyzer Module in Domiciliary Non-Invasive Mechanical Ventilation for Remote COPD Patient Monitoring

Radogna

Siciliano

Sabina

et al. 2020

Sensors

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Smart Breath Analyzers were developed as sensing terminals of a telemedicine architecture devoted to remote monitoring of patients suffering from Chronic Obstructive Pulmonary Disease (COPD) and home-assisted by non-invasive mechanical ventilation via respiratory face mask. The devices based on different sensors (CO2/O2 and Volatile Organic Compounds (VOCs), relative humidity and temperature (R.H. & T) sensors) monitor the breath air exhaled into the expiratory line of the bi-tube patient breathing circuit during a noninvasive ventilo-therapy session; the sensor raw signals are transmitted pseudonymized to National Health Service units by TCP/IP communication through a cloud remote platform. The work is a proof-of-concept of a sensors-based IoT system with the perspective to check continuously the effectiveness of therapy and/or any state of exacerbation of the disease requiring healthcare. Lab tests in controlled experimental conditions by a gas-mixing bench towards CO2/O2 concentrations and exhaled breath collected in a sampling bag were carried out to test the realized prototypes. The Smart Breath Analyzers were also tested in real conditions both on a healthy volunteer subject and a COPD suffering patient.

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Communication and Education Processes Involved in COPD Patient Engagement within the Italian Health System

Recchia

Dodaro²,

Maglie

et al. 2017

Transformative Healthcare Practice Through Patient Engagement

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The World Health Organization has estimated that chronic obstructive pulmonary disease (COPD) is the fourth most common cause of death worldwide. Due to the economic and social extent of the problem, patient engagement must be comprised as a new resource for the achievement of higher health outcomes and lower costs. As many key processes involved in the COPD patient engagement consist of communication and education processes, modelling those processes in a whole framework, including actors and content needs, is a requirement. The main scope of this chapter is contributing to design such a framework within the Italian Health System. Final recommendations suggest to create a synergy among patient engagement and a set of legal tools, namely informed consent, integrated care and advance care planning. The synergy is based on the fact that both patient engagement and those legal tools have a common deep root in the universal principle of patient autonomy.

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Home Long-Term Oxygen Treatment in Italy

Cited by 4 publications

References 101 publications

Changes in blood hemoglobin and blood gases PaO2 and PaCO2 in severe COPD overa three-year telemonitored program of long-term oxygen treatment

Changes in blood hemoglobin and blood gases PaO2 and PaCO2 in severe COPD overa three-year telemonitored program of long-term oxygen treatment

A Low-Cost Breath Analyzer Module in Domiciliary Non-Invasive Mechanical Ventilation for Remote COPD Patient Monitoring

Communication and Education Processes Involved in COPD Patient Engagement within the Italian Health System

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