| Randomised controlled trial of high concentration versus titrated oxygen therapy in severe exacerbations of asthma. | |
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MedLine Citation:
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PMID: 21597111 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The effect on Paco2 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 l/min via medium concentration mask) or titrated oxygen (to achieve oxygen saturations between 93% and 95%) for 60 min. Patients with chronic obstructive pulmonary disease or disorders associated with hypercapnic respiratory failure were excluded. The transcutaneous partial pressure of carbon dioxide (Ptco2) was measured at 0, 20, 40 and 60 min. The primary outcome variable was the proportion of patients with a rise in Ptco2 ≥4 mm Hg at 60 min. RESULTS: The proportion of patients with a rise in Ptco2 ≥4 mm Hg at 60 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 Ptco2 ≥8 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 Ptco2 ≥45 mm Hg received high concentration oxygen therapy, and in five there was an increase in Ptco2 ≥10 mm Hg. CONCLUSION: High concentration oxygen therapy causes a clinically significant increase in Ptco2 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. |
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Authors:
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Kyle Perrin; Meme Wijesinghe; Bridget Healy; Kirsten Wadsworth; Richard Bowditch; Susan Bibby; Tanya Baker; Mark Weatherall; Richard Beasley |
Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2011-05-19 |
Journal Detail:
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Title: Thorax Volume: 66 ISSN: 1468-3296 ISO Abbreviation: Thorax Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-10-17 Completed Date: 2011-12-08 Revised Date: 2012-10-17 |
Medline Journal Info:
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Nlm Unique ID: 0417353 Medline TA: Thorax Country: England |
Other Details:
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Languages: eng Pagination: 937-41 Citation Subset: IM |
Affiliation:
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Medical Research Institute of New Zealand, Private Bag 7902, Wellington 6242, New Zealand. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Asthma / blood, physiopathology, therapy* Blood Gas Monitoring, Transcutaneous / methods Carbon Dioxide / blood Emergency Service, Hospital Female Forced Expiratory Volume / physiology Hospitalization Humans Hypercapnia / blood, etiology Male Middle Aged Oxygen Inhalation Therapy / adverse effects, methods* Partial Pressure Young Adult |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide |
| Comments/Corrections | |
Comment In:
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Thorax. 2012 Sep;67(9):833-4; author reply 834
[PMID:
22188974
]
Thorax. 2011 Nov;66(11):931-2 [PMID: 21685492 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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