Refillable oxygen cylinders may be an alternative for ambulatory oxygen therapy in COPD

Study objectives: To compare, in clinical conditions, the efficacy of refilled oxygen cylinders (O-2-HFs) in improving oxygenation and exercise capacity of patients with COPD during a 6-min walking test. Design: Prospective randomized study with a cross-over design. Setting: A university teaching hospital. Patients: Ten patients with COPD, in a stable state and previously treated with long-term domiciliary oxygen therapy,. Baseline characteristics were as follows: age, 65 +/- 7 years; Pao(2) on room air, 55.4 +/- 6.3 mm Hg; PaCo2 on room air, 46.2 +/- 7.4 mm Hg; FEV1/vital capacity, 47 +/- 7%; and FEV, 30 +/- 7% of predicted value (mean +/- SD). Design: All patients performed three successive 6-min walking tests, the first test in room air and the other tests in a randomized order with either a conventional oxygen cylinder (O-2-C) or an O-2-HF. Measurements and results. The fraction of inspired oxygen (FIO2) delivered by O-2-HFs was significantly lower than the FIO2 delivered by O-2-CS (94.2 +/- 2.6% vs 98.8 +/- 4.9%, p = 0.02). Mean O-2-HF and O-2-C weights before the walking tests were similar (3,510 +/- 251 g and 3,770 +/- 142 g, respectively; p = 0.09). Mean transcutaneous oxygen saturation was similarly improved with both oxygen delivery systems. Mean distances with O-2-C O-2-HF (375 97 m) were not different but significantly improved, as compared with room air (334.5 +/- 90 m; p = 0.03 and 0.02, respectively). Dyspnea sensations were similar for the three tests. Conclusion: O-2-HFs are as efficient as O-2-CS for performing short-term exercises. Because of a lower cost, pressurizing units may be worthwhile for improving ambulatory oxygen therapy and pulmonary rehabilitation programs.