New Perspectives in Oxygen Therapy Titration: Is Automatic Titration the Future?

Arch Bronconeumol (Engl Ed). 2019 Jun;55(6):319-327. doi: 10.1016/j.arbres.2018.09.006. Epub 2018 Nov 7.
[Article in English, Spanish]

Abstract

Oxygen therapy, like all technology-based treatments, is continuously evolving. There are no doubts as to its effectiveness in the treatment of acute and respiratory failure in different clinical scenarios. However, the dosing guidelines for oxygen therapy are not as strict as for other treatments. The use of higher than necessary flows over excessively long periods, derived from the clinician's perception of it as a 'life-saving treatment with few side effects', has led to a rather liberal use of this intervention, despite evidence that overuse and suboptimal adjustment can be harmful. The titration of oxygen therapy, which is traditionally performed manually, has been shown to be beneficial. Recently, new devices have been developed that automatically adjust oxygen flow rates to the needs of each patient, in order to maintain stable oxygen saturation levels. These closed-loop oxygen supply systems can potentially reduce medical error, improve morbidity and mortality, and reduce care costs. Familiarizing the medical community with these technological advances will improve awareness of the risks of the inappropriate use of oxygen therapy. The aim of this paper is to provide an update of recent developments in oxygen therapy titration.

Keywords: COPD; Continuous home oxygen therapy; Dispositivos médicos fisiológicos controlados de circuito cerrado; EPOC; Oxigenoterapia; Oxigenoterapia continua domiciliaria; Oximetry; Oximetría; Oxygen therapy; Oxygen therapy titration; Physiological closed-loop controlled medical devices; Titulación de la oxigenoterapia.

Publication types

  • Review

MeSH terms

  • Adult
  • Algorithms
  • Automation
  • Critical Care
  • Equipment Design
  • Forecasting
  • Humans
  • Hyperoxia / etiology
  • Hyperoxia / prevention & control
  • Hypoxia / etiology
  • Hypoxia / prevention & control
  • Infant
  • Infant, Newborn
  • Oxygen / administration & dosage
  • Oxygen / adverse effects
  • Oxygen Inhalation Therapy / adverse effects
  • Oxygen Inhalation Therapy / instrumentation*
  • Oxygen Inhalation Therapy / methods
  • Oxygen Inhalation Therapy / trends
  • Respiratory Insufficiency / therapy
  • Rheology

Substances

  • Oxygen