title: Titrated oxygen requirement and prognostication in idiopathic pulmonary fibrosis.
abstract: The supplemental oxygen flow rate is a common bedside measure of gas exchange impairment. We aimed to determine whether a titrated oxygen requirement (TOR) predicted mortality in idiopathic pulmonary fibrosis (IPF). We examined 104 adults with IPF enrolled in a prospective cohort study and a validation cohort of 151 adults with a variety of interstitial lung diseases (ILDs). The TOR was defined as the lowest oxygen flow rate required to maintain an oxyhaemoglobin saturation of 96% while standing. Cox proportional hazards models and time-dependent receiver operating characteristic curves were used to examine survival time. A higher TOR was associated with a greater mortality rate independent of forced vital capacity and 6-min walk test results in IPF (adjusted hazard ratio (per 1 L·min(-1)) 1.16, 95% CI 1.06-1.27). The TOR was at least as accurate as pulmonary function and 6-min walk testing at predicting 1-yr mortality. Findings were similar in other ILDs. The TOR is a simple, inexpensive bedside measurement that aids prognostication in IPF.
authors: Division of Pulmonary, Allergy and Critical Care Medicine College of Physicians and Surgeons, Columbia University, 622 W 168th Street, PH-14, Room 104, New York, NY 10032, USA.
authors: J L
authors: JL
authors: Hook
authors: S M
authors: SM
authors: Arcasoy
authors: D
authors: D
authors: Zemmel
authors: M N
authors: MN
authors: Bartels
authors: S M
authors: SM
authors: Kawut
authors: D J
authors: DJ
authors: Lederer
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D017563:Lung Diseases, Interstitial / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy / Q000379:methods* / Q000401:mortality* / Q000592:standards; D010807:Physical Endurance / Q000502:physiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000502:physiology; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology; D016138:Walking