Supplemental Oxygen Therapy in Interstitial Lung Disease: A Narrative Review.

IF 6.8 2区 医学 Q1 RESPIRATORY SYSTEM Annals of the American Thoracic Society Pub Date : 2023-11-01 DOI:10.1513/AnnalsATS.202304-391CME
Kristopher P Clark, Howard B Degenholtz, Kathleen O Lindell, Daniel J Kass
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Abstract

Patients with interstitial lung diseases (ILD) often have hypoxemia at rest and/or with exertion, for which supplemental oxygen is commonly prescribed. The number of patients with ILD who require supplemental oxygen is unknown, although estimates suggest it could be as much as 40%; many of these patients may require high-flow support (>4 L/min). Despite its frequent use, there is limited evidence for the impact of supplemental oxygen on clinical outcomes in ILD, with recommendations for its use primarily based on older studies in patients with chronic obstructive pulmonary disease. Oxygen use in ILD is rarely included as an outcome in clinical trials. Available evidence suggests that supplemental oxygen in ILD may improve quality of life and some exercise parameters in patients whose hypoxemia is a limiting factor; however, oxygen therapy also places new burdens and barriers on some patients that may counter its beneficial effects. The cost of supplemental oxygen in ILD is also unknown but likely represents a significant portion of overall healthcare costs in these patients. Current Centers for Medicare and Medicaid reimbursement policies provide only a modest increase in payment for high oxygen flows, which may negatively impact access to oxygen services and equipment for some patients with ILD. Future studies should examine clinical and quality-of-life outcomes for oxygen use in ILD. In the meantime, given the current limited evidence for supplemental oxygen and considering cost factors and other barriers, providers should take a patient-focused approach when considering supplemental oxygen prescriptions in patients with ILD.

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间质性肺病的补充氧治疗:叙述性综述。
间质性肺病(ILD)患者在休息和/或运动时经常出现低氧血症,通常需要补充氧气。需要补充氧气的ILD患者人数尚不清楚,尽管估计可能高达40%;其中许多患者可能需要高流量支持(>4 L/分钟)。尽管它经常使用,但补充氧气对ILD临床结果的影响证据有限,其使用建议主要基于对慢性阻塞性肺病患者的早期研究。ILD中的氧气使用很少作为临床试验的结果。现有证据表明,在低氧血症是限制因素的患者中,ILD中补充氧气可以改善生活质量和一些运动参数;然而,氧气治疗也给一些患者带来了新的负担和障碍,可能会抵消其有益效果。ILD中补充氧气的成本也是未知的,但可能占这些患者整体医疗成本的很大一部分。目前的医疗保险和医疗补助中心报销政策只适度增加了高氧气流量的支付,这可能会对一些ILD患者获得氧气服务和设备产生负面影响。未来的研究应该检查ILD中氧气使用的临床和生活质量结果。与此同时,鉴于目前补充氧气的证据有限,并考虑到成本因素和其他障碍,提供者在考虑ILD患者的补充氧气处方时应采取以患者为中心的方法。
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来源期刊
Annals of the American Thoracic Society
Annals of the American Thoracic Society Medicine-Pulmonary and Respiratory Medicine
CiteScore
9.30
自引率
3.60%
发文量
0
期刊介绍: The Annals of the American Thoracic Society (AnnalsATS) is the official international online journal of the American Thoracic Society. Formerly known as PATS, it provides comprehensive and authoritative coverage of a wide range of topics in adult and pediatric pulmonary medicine, respiratory sleep medicine, and adult medical critical care. As a leading journal in its field, AnnalsATS offers up-to-date and reliable information that is directly applicable to clinical practice. It serves as a valuable resource for clinical specialists, supporting their formative and continuing education. Additionally, the journal is committed to promoting public health by publishing research and articles that contribute to the advancement of knowledge in these fields.
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