Oxygen Therapy Improves Survival & Exercise in COPD Patients - Research Paper

Introduction

Using supplemental oxygen for long improves the chances of patients with severe resting hypoxemia COPD surviving. However, the role that oxygen plays in patients with moderate hypoxemia and the ones with symptoms of COPD is not clear. Few long-term analysis of supplemental oxygen has indicated beneficial effects in patients, instead of survival. Additionally, supplemental oxygen improves the performance of exercise in the investigation of patients. Thus, it is important for healthcare providers to use evidence-based practice when using oxygen in patients with COPD.

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Delivering and administering high concentrations of oxygen can worsen hypercapnia. Thus, initiating evidence-based practice while attending to patients with COPD will minimize the chances of hypercapnia. Many pathological mechanisms underlie this phenomenon. The separate studies that the US and the UK conducted in the 1970s determined the treatment of hypoxemia in COPD to ascertain whether it would improve mortality. The trials indicated that the long-term use of oxygen therapy improved the survival in these patients when administered for over 15 hours daily (Branson, King, & Giordano, 2019). Thus, for evidence practice, it is important to initiate the prolonged use of oxygen since it improves patient outcome in such a way that it reduces the health care costs at the same time (Fujimoto, 2019). The use of oxygen in COPD patients improves their mortality. The patients who get this treatment are older and their co-morbidities are low.

Studies have revealed that if the uncontrolled administration of oxygen in these patients inhibits the vasoconstriction of the pulmonary, thus causing a worse perfusion/ventilation mismatch. Additionally, CO2 shifts to the right hand, thus dissociating the curve (Fujimoto, 2019). Other mechanisms that underlie this phenomenon relate to a further increase in perfusion/ventilation mismatching because of absorption atelectasis and the fact that the patient breathes more because the oxygen is more than the air (Branson et al., 2019). The initial belief was that the cause of hypercapnia was major because of the reduced hypoxic drive. However, this belief no longer applies after the publication of results, which challenged this hypothesis. As much as the initial consideration was that administering high concentrations of oxygen caused a fall in the minute ventilation, the decrease was transient, and the minute ventilation became lower compared to the initial breathing of room air.

For this reason, an evidence-based practice advocates that the administration of titrated oxygen is ideal. Clinicians should have a universal way of administering oxygen to maintain a SpO2 between the levels of 88% and 92% in a hospital set up for the patients with COPD. This universal application helps to reduce the geographic variations in delivering care. The clinical practice has also listed COPD as the most famous chronic disease to cause hypercapnia. Therefore, vulnerable people have a high probability of risk. These patients include the ones with morbid obesity, cystic fibrosis, obstructive sleep apnea, neuromuscular disorders, patients who have restrictive chest deformities and the ones who use respiratory depressant drugs like benzodiazepines and opioids. For the patients who do not have the possibility of hypercapnic respiratory failure, the evidence-based practice recommendation varies from one professional body to the other. While others advocate for maintaining SpO2 between the levels of 94% and 98%, others perceive that this maintenance should be between 92% and 96%. Whichever the case, evidence-based practice has it that the delivery of the accurate amount of oxygen is appropriate for all the patients (Cousins, Wark, & McDonald, 2016). Administering appropriate amount of oxygen prevents the risks of hypercapnia, and therefore, the health care providers get satisfaction in their roles and give them the satisfaction that they want.

Moreover, health care providers have the confidence to deal with such patients since they gey empowerment from their outcome. Ideally, the providers will incorporate their knowledge and their skills to handle such patients and administer oxygen in the right quantities (Cousins et al., 2016). With the empowerment, encouragement, and role from satisfaction, this evidence-based practice, the health care provider turnover rate will reduce, since the relevant staff will have all the confidence that they need to handle such patients. Studies have also indicated that delivering titrated oxygen reduces mortality by 58% compared to the patients who got a high flow of oxygen (Cousins et al., 2016). When third-party payers see the significant improvement in patients with COPD because of the evidence-based practice, they will increase their reimbursement, and this will give the health care providers an assurance that they get merit for work well done.

Therefore, it is important for health care providers to know when to administer oxygen to the patient. They should ensure that the evidence-based practice they adopt should increase the outcome of the patient and indicate the highest quality care. Thus, whatever health care providers do, they should be aware that patient care comes first. As such, it is essential to try through the means that will provide the best outcome.

References

Branson, R. D., King, A., & Giordano, S. P. (2019). Home Oxygen Therapy Devices: Providing the Prescription. https://doi.org/10.4187/respcare.06850

Cousins, J. L., Wark, P. A., & McDonald, V. M. (2016). Acute oxygen therapy: a review of prescribing and delivery practices. International journal of chronic obstructive pulmonary disease, vol. 11, p. 1067. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888716/

Fujimoto, K. (2019). Anti-disaster Measures in Local Public Entities for Patients Prescribed Long-Term Oxygen Therapy: Have Local Public Entities Made Appropriate Anti-disaster Measures for Patients Prescribed Long-Term Oxygen Therapy? In Disaster and Respiratory Diseases (pp. 149-163). Springer, Singapore. Retrieved from https://link.springer.com/chapter/10.1007/978-981-13-2598-4_11