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Topic: Oxygen (Read 243 times) |
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maria9
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Here is an article I read recently, interesting how they don't think the 12-15 lpm is any more helpful for us than the 7-10 lpm that is generally recommended or prescribed. In my most recent bout with these hellish monsters, I was very specific with the doc I needed a regulator that could put out 12 -15 lpm and a non-rebreather mask. The medical supply company called me before delivering the O2 and said the doctors orders had indicated 7-10 lpm and the nasal canulas. I said wrong and bless their hearts the medical supply company did show up with the right regulator and mask.
Marsha
1: Headache. 2005 Jan;45(1):98. Related Articles, Links
CLUSTER.
[No authors listed]
Rozen TD. High oxygen-flow rates for cluster headache. Neurology. 2004;63:593 The two most effective cluster abortive agents are injectable sumatriptan and inhaled oxygen. Because most cluster headache sufferers are cigarette smokers and at high risk of coronary artery disease, many develop contraindications to triptans. Oxygen, the safest of all cluster therapies, is not effective for every patient. In Kudrow's landmark study, 75% of patients responded to 100% oxygen at 7 L/min, although only 57% of older chronic cluster headache patients had relief. A recent study documented a gender difference in response to oxygen because only 59% of female cluster patients responded to oxygen, whereas 87% of men did. In most textbooks and articles on cluster headache treatment, patients are instructed to use 100% oxygen via a nonrebreather face mask at 7 to 10 L/min. The rationale behind this prescribed oxygen-flow rate is unknown but has become doctrine since the Kudrow study. Prescribing higher flow rates of oxygen up to 12 L/min has recently been suggested, but there is no documentation that this may improve efficacy. Higher oxygen-flow rates (up to 15 L/min) are not known to benefit cluster headache patients refractory to standard oxygen therapy. Three cluster headache patients who demonstrated no response to standard oxygen therapy were exposed to higher flow rates of oxygen (14 to 15 L/min) to assess response. Comments: Once again, Dr. Todd Rozen's observations will change my clinical practice!-Stewart J. Tepper, MD I have questions: Were these empirical observations or do Drs. Kudrow and Rozen know how rate of flow affects oxygen delivery? Is oxygen uptake higher with higher flows? After all, 100% oxygen is 100% oxygen unless under hyperbaric pressure! Perhaps higher flow rates dry the nasopharyx to a greater extent. If patients perceive a higher flow rate, might this be an enhanced placebo effect? It seems like an interesting study to be conducted, and it would be useful to test if using nasal cannulae is just as good. Pulse oximetry and arterialized capillary blood gases could be used to monitor oxygen saturation and CO(2) retention/carboxyhaemoglobin levels in smokers.-David S. Millson, MD.
PMID: 15663630 [PubMed - as supplied by publisher]
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BobG
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Re: Oxygen
« Reply #1 on: Feb 5th, 2005, 10:08pm » |
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Quote:| Prescribing higher flow rates of oxygen up to 12 L/min has recently been suggested, but there is no documentation that this may improve efficacy. |
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I guess the hundreds of messages at this board by actual cluster sufferers recommending 12 LPM don't count as "documentation".
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Pinkfloyd
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Re: Oxygen
« Reply #2 on: Feb 5th, 2005, 11:29pm » |
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on Feb 5th, 2005, 10:08pm, BobG wrote:
I guess the hundreds of messages at this board by actual cluster sufferers recommending 12 LPM don't count as "documentation". |
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If a tree falls in a forest and there is no doctor to hear it, did it really fall?
If this was a board that doctors or researchers hung out, maybe one of them would have noticed the pattern and done something about it.
Maybe OUCH should complile all these posts and present some stats to the medical community.
It's possible 80% of cluster sufferers ARE helped with 7-10lpm. Just as we're told 80% are helped by typical medication. I still believe the people that frequent these types of boards looking for help, are the remaining 20%. If 80% of that 20% need 12-15lpm, someone should be told rather than doctors telling their "problem patients" that if 7-10lpm doesn't work, forget 02?
just my .02
Bobw
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