Oxygen compared to air driven nebulisers for acute exacerbations of COPD: a randomised controlled trial

Bardsley, George; McKinstry, Steve; Pilcher, Janine; Fingleton, James; Weatherall, Mark; Beasley, Richard

doi:10.1183/1393003.congress-2017.pa684

Cited by 2 publications

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“…To maintain adequate oxygen saturation for the patient who deteriorates, a high fraction of inspired oxygen (FIO 2 ) may be required. For this reason, patients who need high FIO 2 should receive senior clinician review and transfer to an area where there are appropriate numbers of competent staff able to provide more intensive monitoring and therapy [ 5 , 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitude, and practice of health professionals for oxygen therapy working in South Gondar zone hospitals, 2021: multicenter cross-sectional study

Chekol

Mekonen

Aemro

et al. 2022

BMC Health Serv Res

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Introduction Therapeutic oxygen should be administered by competent healthcare providers who possess the required competencies of knowledge, skill, and judgment/abilities to make clinical decisions regarding the administration of oxygen. Therefore, this study aimed to assess the knowledge, attitude, and practice of health professionals towards oxygen therapy. Methods A multicenter institutional-based cross-sectional study was conducted among 218 health professionals. The assessment was done with a total of 31 questions. After data cleanup analysis was done with SPSS software. Descriptive, chi-square test, bivariable and multivariable analysis were done accordingly. A p-value of ≤0.05 was considered to have a significant association with the outcome variables. Results Among 218 participants, most of the participants (92.7%) were in the age range of less than 40 years old. Nurses were the most responding professions followed by physicians and midwifes. From the participants, around 54.6, 54.6, and 65.1% of respondents answered above the means score of knowledge, attitude and practice questions respectively. Getting training (AOR- 4.15, CI- 1.15-14.6), work experiences of less than 4 years (AOR- 2.54, 95%CI- (1.28-5.05), and availability of guidelines (AOR- 11.5, CI- 3.35-39.6) were significantly associated with knowledge level. Also work experience of fewer than 4 years (AOR- 3.41, 95%CI- (1.58-7.35) and presence of periodic maintenance and supply of oxygen therapy devices (AOR- 4.32, 95% CI- (1.44-12.9) were associated with practice level. Similarly, work experiences < 4 years (AOR- 8.6, 95%CI- (2.6-29) and getting training (AOR- 21.4, 95%CI-(2.7- 27.3) has a positive (direct) association with the level of attitude, and poor level of knowledge (AOR- 12.1, 95%CI (3.42-42.9) was contributed for negative attitude. Conclusion This study concluded that 54.6, 54.6, and 65.1% of participants have a good level of knowledge, positive attitude, and good level of practice towards oxygen therapy respectively.

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Section: Introductionmentioning

confidence: 99%

Knowledge, attitude, and practice of health professionals for oxygen therapy working in South Gondar zone hospitals, 2021: multicenter cross-sectional study

Chekol

Mekonen

Aemro

et al. 2022

BMC Health Serv Res

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“…The preliminary results of this study were submitted as an abstract to the ERS 2017 Congress, and presented as a poster [ 18 ].…”

Section: Acknowledgementsmentioning

confidence: 99%

Oxygen versus air-driven nebulisers for exacerbations of chronic obstructive pulmonary disease: a randomised controlled trial

et al. 2018

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BackgroundIn exacerbations of chronic obstructive pulmonary disease, administration of high concentrations of oxygen may cause hypercapnia and increase mortality compared with oxygen titrated, if required, to achieve an oxygen saturation of 88–92%. Optimally titrated oxygen regimens require two components: titrated supplemental oxygen to achieve the target oxygen saturation and, if required, bronchodilators delivered by air-driven nebulisation. The effect of repeated air vs oxygen-driven bronchodilator nebulisation in acute exacerbations of chronic obstructive pulmonary disease is unknown. We aimed to compare the effects of air versus oxygen-driven bronchodilator nebulisation on arterial carbon dioxide tension in exacerbations of chronic obstructive pulmonary disease.MethodsA parallel group double-blind randomised controlled trial in 90 hospital in-patients with an acute exacerbation of COPD. Participants were randomised to receive two 2.5 mg salbutamol nebulisers, both driven by air or oxygen at 8 L/min, each delivered over 15 min with a 5 min interval in-between. The primary outcome measure was the transcutaneous partial pressure of carbon dioxide at the end of the second nebulisation (35 min). The primary analysis used a mixed linear model with fixed effects of the baseline PtCO2, time, the randomised intervention, and a time by intervention interaction term; to estimate the difference between randomised treatments at 35 min. Analysis was by intention-to-treat.ResultsOxygen-driven nebulisation was terminated in one participant after 27 min when the PtCO2 rose by > 10 mmHg, a predefined safety criterion. The mean (standard deviation) change in PtCO2 at 35 min was 3.4 (1.9) mmHg and 0.1 (1.4) mmHg in the oxygen and air groups respectively, difference (95% confidence interval) 3.3 mmHg (2.7 to 3.9), p < 0.001. The proportion of patients with a PtCO2 change ≥4 mmHg during the intervention was 18/45 (40%) and 0/44 (0%) for oxygen and air groups respectively.ConclusionsOxygen-driven nebulisation leads to an increase in PtCO2 in exacerbations of COPD. We propose that air-driven bronchodilator nebulisation is preferable to oxygen-driven nebulisation in exacerbations of COPD.Trial registrationAustralian New Zealand Clinical Trials Registry number ACTRN12615000389505. Registration confirmed on 28/4/15.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0720-7) contains supplementary material, which is available to authorized users.

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Oxygen compared to air driven nebulisers for acute exacerbations of COPD: a randomised controlled trial

Cited by 2 publications

References 0 publications

Knowledge, attitude, and practice of health professionals for oxygen therapy working in South Gondar zone hospitals, 2021: multicenter cross-sectional study

Knowledge, attitude, and practice of health professionals for oxygen therapy working in South Gondar zone hospitals, 2021: multicenter cross-sectional study

Oxygen versus air-driven nebulisers for exacerbations of chronic obstructive pulmonary disease: a randomised controlled trial

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