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June 20, 1986, Vol 255, No. 23 >
ARTICLE | June 20, 1986

Current Oxygen Prescribing Practices: Title and subTitle BreakProblems and Prospects FREE

Morton S. Skorodin, MD
[+] Author Affiliations

Reprint requests to Veterans Administration Hospital, Respiratory Care Department, 111H, Hines, IL 60141 (Dr Skorodin).


JAMA. 1986;255(23):3283-3285. doi:10.1001/jama.1986.03370230089038
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References

REGULATIONS and prescribing practices dealing with long-term home and ambulatory oxygen supplementation for patients with chronic lung disease are currently in a state of flux. Clearly, the move is on to limit this modality as much as possible because of its great expense.

Changes in Oxygen Reimbursement Policy  As recently as March 1985, Petty1 recommended the following patient selection criteria: (1) stable clinical state with optimum medical therapy, eg, bronchodilator, antibiotics, corticosteroids (if indicated), and freedom from exacerbations of bronchitis or heart failure; (2) arterial blood gas analysis conducted on at least two occasions with the subject breathing room air for at least 20 minutes; (3) room-air arterial oxygen pressure (Pao2) consistently (three weeks or more) less than 55 mg Hg or consistently 55 to 59 mm Hg with clinical diagnosis of cor pulmonale, a hematocrit exceeding 55%, or both (entry criteria for the Nocturnal Oxygen Therapy Trial

REFERENCES

1 +
Petty TL:  Definitive criteria for prescribing home oxygen systems . Respir Ther 1985;;15:13-21.
2 +
Nocturnal Oxygen Therapy Trial Group:  Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease . Ann Intern Med 1980;;93:391-398.
3 +
Petty TL:  Who needs home oxygen? Am Rev Respir Dis 1985;; 131:930-931.
4 +
Woodcock AA, Gross ER, Geddis DM:  Oxygen relieves breathlessness in 'pink puffers.' Lancet 1981;;1:907-909.
5 +
Greentree LB:  Home oxygen therapy: A proposal . Am Rev Respir Dis 1985;;131:932-933.
6 +
Medical Research Council Working Party:  Long-term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema . Lancet 1981;;1:681-686.
7 +
Heaton RK, Grant I, McSweeny AJ, et al:  Psychologic effects of continuous and nocturnal oxygen therapy in hypoxemic chronic obstructive pulmonary disease . Arch Intern Med 1983;;143:1941-1947.
8 +
Gibson GE, Pulsinelli W, Blass JP, et al:  Brain dysfunction in mild to moderate hypoxia . Am J Med 1981;;70:1247-1254.
9 +
Bye PTP, Esau SA, Levy RD, et al:  Ventilatory muscle function during exercise in air and oxygen in patients with chronic air-flow limitation . Am Rev Respir Dis 1985;;132:236-240.
10 +
Bye PTP, Esau SA, Walley KR, et al:  Ventilatory muscles during exercise in air and oxygen in normal men . J Appl Physiol 1984;;56:464-471.
11 +
Pardy RL, Bye PTP:  Diaphragmatic fatigue in normoxia and hyperoxia . J Appl Physiol 1985;;58:738-742.
12 +
Tirlapur VG, Mir MA:  Nocturnal hypoxemia and associated electrocardiographic changes in patients with chronic obstructive airways disease . N Engl J Med 1982;;306:125-130.
13 +
Boysen PG, Block AJ, Wynne JW, et al:  Nocturnal pulmonary hypertension in patients with chronic obstructive pulmonary disease . Chest 1979;;76:536-542.
14 +
Block AJ, Boysen PG, Wynne JW:  The origins of cor pulmonale: A hypothesis . Chest 1979;;75:109-110.
15 +
Ashutosh K, Mead G, Dunsky M:  Early effects of oxygen administration and prognosis in chronic obstructive pulmonary disease and cor pulmonale . Am Rev Respir Dis 1983;;127:399-404.
16 +
Leitch AG, Clancy LJ, Costello JF, et al:  Effect of intravenous infusion of salbutamol on ventilatory response to carbon dioxide and hypoxia and on the heart rate and plasma potassium in normal men . Br Med J 1976;;1:365-367.
17 +
McDevitt DG, Shanks RG, Swanton JG:  Further observations on the cardiotoxicity of isoprenaline during hypoxia . Br J Pharmacol 1974;; 50:335-344.
18 +
Collins JM, McDevitt DG, Shanks RG, et al:  The cardiotoxicity of isoprenaline during hypoxia . Br J Pharmacol 1969;;36:35-45.
19 +
Flenley DC, Warren PM:  Gas exchange and acid-base balance in bronchial asthma , in Weiss EB, Segal MS, Stein M (eds): Bronchial Asthma Mechanisms and Therapeutics , ed 2. Boston, Little Brown & Co, 1985;.
20 +
Skorodin MS, Gross NJ, Druz W, et al:  The regional distribution of ventilation in obstructive and restrictive disease: Demonstration with 81m krypton , abstracted. Am Rev Respir Dis 1983;;127:268.
21 +
Kaplan E, Gergans GA, Milo TJ, et al:  Dynamic and functional imaging of the lung with krypton-81m , in Paras P, Thiessen JW (eds): Single-Photon Ultrashort-Lived Radionuclides . Springfield, Va, National Technical Information Service, 1985;, pp 54-66.
22 +
Sovijarvi ARA, Poyhonen L, Kellomaki L, et al:  Effects of acute and long-term bronchodilator treatment on regional lung function in asthma assessed with krypton-81m and technetium-99m-labelled macroaggregates . Thorax 1982;;37:516-520.
23 +
Sly RM:  Increases in deaths from asthma . Ann Allergy 1984;; 53:20-25.
24 +
Grant IWB:  Asthma in New Zealand . Br Med J 1983;;286:374-377.
25 +
Crapo RO:  ATS arterial blood gas proficiency testing program results from June 1983 . Am Thoracic Soc News 1984;;10:42.
26 +
Clark JM, Lambertsen CJ:  Pulmonary oxygen toxicity: A review . Pharm Rev 1971;;23:37-133.
27 +
Williams BT, Nicholl JP:  Prevalence of hypoxaemic chronic obstructive lung disease with reference to long-term oxygen therapy . Lancet 1985;;2:368-372.
28 +
 Long-term domiciliary oxygen therapy . Lancet 1985;;2:365-367.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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1 +
Petty TL:  Definitive criteria for prescribing home oxygen systems . Respir Ther 1985;;15:13-21.
2 +
Nocturnal Oxygen Therapy Trial Group:  Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease . Ann Intern Med 1980;;93:391-398.
3 +
Petty TL:  Who needs home oxygen? Am Rev Respir Dis 1985;; 131:930-931.
4 +
Woodcock AA, Gross ER, Geddis DM:  Oxygen relieves breathlessness in 'pink puffers.' Lancet 1981;;1:907-909.
5 +
Greentree LB:  Home oxygen therapy: A proposal . Am Rev Respir Dis 1985;;131:932-933.
6 +
Medical Research Council Working Party:  Long-term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema . Lancet 1981;;1:681-686.
7 +
Heaton RK, Grant I, McSweeny AJ, et al:  Psychologic effects of continuous and nocturnal oxygen therapy in hypoxemic chronic obstructive pulmonary disease . Arch Intern Med 1983;;143:1941-1947.
8 +
Gibson GE, Pulsinelli W, Blass JP, et al:  Brain dysfunction in mild to moderate hypoxia . Am J Med 1981;;70:1247-1254.
9 +
Bye PTP, Esau SA, Levy RD, et al:  Ventilatory muscle function during exercise in air and oxygen in patients with chronic air-flow limitation . Am Rev Respir Dis 1985;;132:236-240.
10 +
Bye PTP, Esau SA, Walley KR, et al:  Ventilatory muscles during exercise in air and oxygen in normal men . J Appl Physiol 1984;;56:464-471.
11 +
Pardy RL, Bye PTP:  Diaphragmatic fatigue in normoxia and hyperoxia . J Appl Physiol 1985;;58:738-742.
12 +
Tirlapur VG, Mir MA:  Nocturnal hypoxemia and associated electrocardiographic changes in patients with chronic obstructive airways disease . N Engl J Med 1982;;306:125-130.
13 +
Boysen PG, Block AJ, Wynne JW, et al:  Nocturnal pulmonary hypertension in patients with chronic obstructive pulmonary disease . Chest 1979;;76:536-542.
14 +
Block AJ, Boysen PG, Wynne JW:  The origins of cor pulmonale: A hypothesis . Chest 1979;;75:109-110.
15 +
Ashutosh K, Mead G, Dunsky M:  Early effects of oxygen administration and prognosis in chronic obstructive pulmonary disease and cor pulmonale . Am Rev Respir Dis 1983;;127:399-404.
16 +
Leitch AG, Clancy LJ, Costello JF, et al:  Effect of intravenous infusion of salbutamol on ventilatory response to carbon dioxide and hypoxia and on the heart rate and plasma potassium in normal men . Br Med J 1976;;1:365-367.
17 +
McDevitt DG, Shanks RG, Swanton JG:  Further observations on the cardiotoxicity of isoprenaline during hypoxia . Br J Pharmacol 1974;; 50:335-344.
18 +
Collins JM, McDevitt DG, Shanks RG, et al:  The cardiotoxicity of isoprenaline during hypoxia . Br J Pharmacol 1969;;36:35-45.
19 +
Flenley DC, Warren PM:  Gas exchange and acid-base balance in bronchial asthma , in Weiss EB, Segal MS, Stein M (eds): Bronchial Asthma Mechanisms and Therapeutics , ed 2. Boston, Little Brown & Co, 1985;.
20 +
Skorodin MS, Gross NJ, Druz W, et al:  The regional distribution of ventilation in obstructive and restrictive disease: Demonstration with 81m krypton , abstracted. Am Rev Respir Dis 1983;;127:268.
21 +
Kaplan E, Gergans GA, Milo TJ, et al:  Dynamic and functional imaging of the lung with krypton-81m , in Paras P, Thiessen JW (eds): Single-Photon Ultrashort-Lived Radionuclides . Springfield, Va, National Technical Information Service, 1985;, pp 54-66.
22 +
Sovijarvi ARA, Poyhonen L, Kellomaki L, et al:  Effects of acute and long-term bronchodilator treatment on regional lung function in asthma assessed with krypton-81m and technetium-99m-labelled macroaggregates . Thorax 1982;;37:516-520.
23 +
Sly RM:  Increases in deaths from asthma . Ann Allergy 1984;; 53:20-25.
24 +
Grant IWB:  Asthma in New Zealand . Br Med J 1983;;286:374-377.
25 +
Crapo RO:  ATS arterial blood gas proficiency testing program results from June 1983 . Am Thoracic Soc News 1984;;10:42.
26 +
Clark JM, Lambertsen CJ:  Pulmonary oxygen toxicity: A review . Pharm Rev 1971;;23:37-133.
27 +
Williams BT, Nicholl JP:  Prevalence of hypoxaemic chronic obstructive lung disease with reference to long-term oxygen therapy . Lancet 1985;;2:368-372.
28 +
 Long-term domiciliary oxygen therapy . Lancet 1985;;2:365-367.

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