Twenty-four-hour ambulatory oximetry monitoring in a patient with idiopathic pulmonary fibrosis for assisting in the discharge instruction on activities of daily living: a case report

J Phys Ther Sci. 2020 Nov;32(11):768-771. doi: 10.1589/jpts.32.768. Epub 2020 Nov 11.

Abstract

[Purpose] Patients with idiopathic pulmonary fibrosis (IPF) often develop remarkable exercise-induced hypoxemia and are hospitalized for management. The pre-discharge management of activities of daily living (ADL) should determine the amount of exercise-induced hypoxemia permitted during daily activities and inform concrete instructions based on these results. This clinical report aimed to promote 24-hour ambulatory oximetry monitoring in a patient with IPF to guide the pre-discharge management of ADL. [Participant and Methods] Our patient was a 67-year-old male with IPF. He was hospitalized and scheduled to be discharged after introduction of home oxygen therapy. Prior to discharge, we conducted a 24-hour ambulatory oximetry monitoring in the patient's home. We administered instructions on ADL based on these results. Furthermore, 1 day after discharge, we monitored his oxygen saturation level during ADL in his home. [Results] During the pre-discharge monitoring, the patient experienced hypoxemia during bathing, with a minimum oxygen saturation (SpO2) level of 87% and SpO2 level of <90% for 14.3% of the time. The patient was instructed on bathing by a physical therapist before discharge; this led to decreased desaturation, as the patient's SpO2 was <90% for 7.7% of the time. [Conclusion] Twenty-four-hour ambulatory oximetry monitoring is effective in guiding the pre-discharge management of ADL in the home with home oxygen therapy for patients with IPF.

Keywords: Discharge instruction; Idiopathic pulmonary fibrosis; Pulse oximetry.

Publication types

  • Case Reports