Resp Care
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With Jan's presentation, the conference concluded. In looking back on it, I think it is obvious that the group heard a very comprehensive, state-of-the-art review of this very important topic. Obviously, LTOT has enormous clinical and financial impact for millions of patients around the world. ⋯ Second, our 3 industry sponsors not only provided critical funding support but also gave the group important perspectives during many of the discussions. These kinds of industry-profession collaborations benefit everyone. Finally, I'd like to extend my congratulations to all the speakers for jobs well done and to thank them for making my job as summarizer an enjoyable one.
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In general, based on the above studies of the effects of supplemental oxygen on reducing mortality and improving sleep and exercise function in certain patient groups, patients whose disease is stable on a full medical regimen with PaO2 < or = 55 mm Hg (SaO2 < or = 88%) should be considered for LTOT. Patients with PaO2 of 55-59 mm Hg with signs of tissue hypoxemia (i.e., cor pulmonale, polycythemia, impaired cognition) should also be considered for LTOT. ⋯ Indications for LTOT endorsed by the American Thoracic Society and published in the "Standards for the Diagnosis and Care of Patients with COPD" are shown in Table 6. More research is required to investigate the use of supplemental oxygen in patients who suffer nocturnal desaturation but do not have signs of end organ dysfunction, those who have an improvement in dyspnea with supplemental oxygen, and in normoxemic patients with impaired exercise performance who improve while inspiring supplemental oxygen.
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The story of the development of oxygen and its role in mitigating the ravages of chronic stable hypoxemia have been fascinating. Today, over one million Americans receive home oxygen each day, usually for COPD, from one of the three available systems. The future requires less expensive, highly portable, and practical devices for use during all activities of daily living.