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Home oxygen therapy: re-thinking the role of devices
Authors:Andrea S. Melani  Piersante Sestini  Paola Rottoli
Affiliation:1. Fisiopatologia e Riabilitazione Respiratoria, Dipartimento Vasi, Cuore e Torace, Policlinico Le Scotte, Azienda Ospedaliera Universitaria Senese, Siena, Italy;2. Clinica delle Malattie dell’Apparato Respiratorio, Dipartimento di Medicine Specialistica, Policlinico Le Scotte, Azienda Ospedaliera Universitaria Senese, Siena, Italy;3. Clinica delle Malattie dell’Apparato Respiratorio, Dipartimento di Medicine Specialistica, Policlinico Le Scotte, Azienda Ospedaliera Universitaria Senese, Siena, Italy
Abstract:Introduction: A range of devices are available for delivering and monitoring home oxygen therapy (HOT). Guidelines do not give indications for the choice of the delivery device but recommend the use of an ambulatory system in subjects on HOT whilst walking.

Areas covered: We provide a clinical overview of HOT and review traditional and newer delivery and monitoring devices for HOT. Despite relevant technology advancements, clinicians, faced with many challenges when they prescribe oxygen therapy, often remain familiar to traditional devices and continuous flow delivery of oxygen. Some self-filling delivery-less devices could increase the users’ level of independence with ecological advantage and, perhaps, reduced cost. Some newer portable oxygen concentrators are being available, but more work is needed to understand their performances in different diseases and clinical settings. Pulse oximetry has gained large diffusion worldwide and some models permit long-term monitoring. Some closed-loop portable monitoring devices are also able to adjust oxygen flow automatically in accordance with the different needs of everyday life. This might help to improve adherence and the practice of proper oxygen titration that has often been omitted because difficult to perform and time-consuming.

Expert commentary: The prescribing physicians should know the characteristics of newer devices and use technological advancements to improve the practice of HOT.

Keywords:Oxygen  chronic obstructive pulmonary disease (COPD)  dyspnoea  symptom management  interstitial lung disease  technological innovations  medical devices  hypoxemia
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