Document Detail


Randomised controlled trial of high concentration versus titrated oxygen therapy in severe exacerbations of asthma.
MedLine Citation:
PMID:  21597111     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background The effect on Paco(2) of high concentration oxygen therapy when administered to patients with severe exacerbations of asthma is uncertain. Methods 106 patients with severe exacerbations of asthma presenting to the Emergency Department were randomised to high concentration oxygen (8&emsp14;l/min via medium concentration mask) or titrated oxygen (to achieve oxygen saturations between 93% and 95%) for 60&emsp14;min. Patients with chronic obstructive pulmonary disease or disorders associated with hypercapnic respiratory failure were excluded. The transcutaneous partial pressure of carbon dioxide (Ptco(2)) was measured at 0, 20, 40 and 60&emsp14;min. The primary outcome variable was the proportion of patients with a rise in Ptco(2) ≥4&emsp14;mm Hg at 60&emsp14;min. Results The proportion of patients with a rise in Ptco(2) ≥4&emsp14;mm Hg at 60&emsp14;min was significantly higher in the high concentration oxygen group, 22/50 (44%) vs 10/53 (19%), RR 2.3 (95% CI 1.2 to 4.4, p<0.006). The high concentration group had a higher proportion of patients with a rise in Ptco(2) ≥8&emsp14;mm Hg, 11/50 (22%) vs 3/53 (6%), RR 3.9 (95% CI 1.2 to 13.1, p=0.016). All 10 patients with a final Ptco(2) ≥45&emsp14;mm Hg received high concentration oxygen therapy, and in five there was an increase in Ptco(2) ≥10&emsp14;mm Hg. Conclusion High concentration oxygen therapy causes a clinically significant increase in Ptco(2) in patients presenting with severe exacerbations of asthma. A titrated oxygen regime is recommended in the treatment of severe asthma, in which oxygen is administered only to patients with hypoxaemia, in a dose that relieves hypoxaemia without causing hyperoxaemia. Clinical trial number ACTRN12607000131459.
Authors:
Kyle Perrin; Meme Wijesinghe; Bridget Healy; Kirsten Wadsworth; Richard Bowditch; Susan Bibby; Tanya Baker; Mark Weatherall; Richard Beasley
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-19
Journal Detail:
Title:  Thorax     Volume:  -     ISSN:  1468-3296     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Medical Research Institute of New Zealand, Wellington, New Zealand.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Futile treatment, junior doctors and role virtues.
Next Document:  Neural respiratory drive as a physiological biomarker to monitor change during acute exacerbations o...