[Long-term oxygen therapy in Switzerland].
In Switzerland long-term oxygen treatment is chiefly performed with oxygen concentrators provided by the Swiss Association against Tuberculosis and Pulmonary Diseases through its cantonal leagues. Prescription and supervision are carried out according to the Association's guidelines. To assess compliance with these guidelines, the prescription forms of 447 patients (1981-1985) were analyzed concerning diagnosis, lung function and blood gases. Of the 398 diagnoses mentioned, 73% were COPD, 16% restrictive syndromes and 11% cardiovascular diseases (including cor pulmonale). Lung function results were given in 81% of the total but in only 73% and 67% of two non-COPD groups. Blood gases at ambiant air were given in 92% and under oxygen at the flow chosen for treatment in 72%. At ambiant air the PaO2 was greater than 7.33 kPa in 21% (8.18 +/- 0.85 kPa) and less than 5.33 kPa in 19% (4.86 +/- 0.33 kPa). - These results show that prescription criteria are not always correctly met, especially in non-COPD patients. They also suggest that long-term oxygen treatment is often prescribed mainly on the basis of clinical criteria, despite a PaO2 which would not require it, and also in unstable state, as indicated by the high proportion of cases with very low PaO2. The rationale behind the guidelines should be explained more clearly to prescribing doctors, in order to confine this difficult and costly treatment to patients who really need it.
Bongard
J P
JP
Département de médecine, Hôpital cantonal universitaire, Genève.
de Haller
R
R
D000368:Aged; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis; D008173:Lung Diseases, Obstructive / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000592:standards; D010313:Partial Pressure; D055656:Prescriptions / Q000592:standards*; D012131:Respiratory Insufficiency / Q000628:therapy; D013557:Switzerland
D010100:Oxygen
Oxygénothérapie au long cours en Suisse.