家庭氧疗

现在老干部都处于"两高期",身体机能逐渐退化,部分身患多种疾病,同时老首长比较恋家,除急症、重症外,大部分时间都在家休养.这给干休所卫生保健工作带来很大压力.笔者根据自己工作经验,认为很有必要开展"家庭氧疗"--通过方便的手段,提高血氧饱和度,从而纠正或缓解机体缺氧状态.     

Home oxygen therapy

Home oxygen therapy is clearly beneficial for the chronically hypoxemic patient. Compressed gas, liquid oxygen and oxygen concentrators are the primary oxygen sources for home use. A number of oxygen-conserving devices are now available and may improve compliance. Reservoir cannulas, demand oxygen delivery systems and transtracheal oxygen are the latest examples of oxygen-conserving techniques.     

Home oxygen therapy

Clinical applications for the use of oxygen have extended beyond the hospital setting to home therapy. In patients with hypoxemic chronic obstructive pulmonary disease, long-term administration of oxygen has been substantiated as beneficial in terms of improved survival, decreased hospitalization, increased exercise capability and endurance, enhanced neuropsychologic function, and alleviation of hemodynamic abnormalities. Continuous oxygen therapy with use of an ambulatory system consistently provides the greatest benefit. New developments that have facilitated home oxygen therapy are conservation methods that allow flow of oxygen only during inspiration or storage of oxygen during expiration and cosmetic improvements for concealing devices used to administer oxygen. Controlled studies are needed to determine the optimal duration and method of administration of oxygen and the selection of appropriate candidates for long-term home oxygen therapy.     

Home oxygen therapy for COPD

When well-documented hypoxemia does not respond to the more conventional methods of treating chronic obstructive pulmonary disease, home oxygen therapy should be considered. The convenience, cost, and practicality of options now available for providing long-term home therapy and criteria for choosing candidates for such treatment are discussed.     

Home oxygen therapy for children

The number of children who need home oxygen therapy is increasing, and there is a growing need to support both them and their parents. Families must also understand the practical and safety issues surrounding the supply of oxygen cylinders. A best practice statement was developed to ensure consistency and high standards of practice. It covers a range of areas including risk assessment, information for parents and carers, discharge planning, the provision of equipment and the use of oxygen therapy outside the home.     

Home oxygen therapy: nursing care

The authors present a brief historical summary of the use of oxygen therapy in a patient's home from its start in 1970 to the present time, analyzing the controversies which have developed and the interest in oxygen therapy in a patient's home. For a review of the indications, initial evaluation, requirements and dose of this treatment, one should consult the article written by these authors published in Revista Rol de Enfermeria 2000; 23(4):257-261. In continuation, the authors explain the main nursing care which a patient receiving oxygen therapy at home requires, the circumstances which can compromise its efficiency, its secondary effects and complications, and the follow-up that is necessary to carry out on patients using this therapy.     

Home oxygen in remote areas.

Delivering long-term oxygen therapy in the homes of persons who live in remote areas can be a problem. Four isolated areas in North America--rural Manitoba, Canada; the Northwest Territories of Canada; Alaska; and the Colorado mountains--have home oxygen programs that illustrate that these problems can be overcome. The indications for home oxygen in remote areas are the same as elsewhere, and the local physicians must be educated in the indications for such therapy. An oxygen exchanger should be used wherever electricity is available. Patients in remote areas should also be supplied with a large standby oxygen cylinder and an E cylinder for mobility. Installation of home oxygen equipment can be done by a respiratory therapist, by an equipment dealer, or by the patient or a trained relative. Maintenance of the equipment can also be performed by these persons, as well as by a nurse or paramedic.     

Home oxygen therapy. Why, when, and how to write a proper prescription

Long-term oxygen therapy can be a lifeline for patients with chronic lung disease. Recent changes in Medicare reimbursement criteria have made it imperative that physicians understand all aspects of the treatment. In this article, Dr O'Donohue describes the indications for and benefits of home oxygen therapy and discusses prescribing problems and physician responsibility.     

Home oxygen therapy (HOT) for patients with heart failure associated with sleep disturbed breathing

Recently, there is increasing evidence that sleep apnea may adversely affect pathophysiology and outcomes of congestive heart failure (CHF). Repetitive nocturnal apneas may worsen CHF through a number of mechanisms including the repetitive arterial oxygen desaturation, increased left ventricular afterload, or an activation of sympathetic nervous system. Although central sleep apnea (CSA) is relatively rare, prospective studies revealed that 33 to 82 % of patients with CHF have evidence of CSA and characteristic Cheyne-Stokes respiration (CSR). We assessed an efficacy of nasal O2 therapy at night using a conventional O2 concentrator in ambulatory patients with stable CHF and CSR. O2 resulted in a significant improvement of sleep together with an increase in left ventricular function and quality of life. Therefore, home oxygen therapy(HOT) can be a valuable nonpharmacological option for the treatment of patients with CHF and CSR-CSA.