Take it from Abraham Lincoln:

Tuesday, March 23, 2010

CLEVELAND - Home respiratory professionals aren't all that impressed with a new clinical study on oxygen conserving devices.

The recent study from Case Western Reserve University makes the case that no two conservers perform the same way. That's something "respiratory therapists have been saying that for well over 10 years," said Lou Kaufman, vice president of patient/clinical services at Roberts Home Medical Rockville, Md.

"It just shows again that every once in a while a group of docs writes an editorial that says, 'Gee these things don't work or they don't work or they all work differently,'" Kaufman said. "I don't understand the point. They are all different. That is correct."

The point, said Bob McCoy, managing director of Valley Inspired Products, is that the researchers missed the point.

"To paraphrase Abraham Lincoln: These devices will work on all of the people some of the time, some of the people all of the time but not all of the people all of the time," said McCoy, who has performed in-depth research on conservers.

The bottom line, say McCoy and other clinicians, is nothing new: Respiratory therapists must choose a conserver that best meets a patient's clinical needs, then titrate that conserver so that it delivers the necessary amount of oxygen.

"My philosophy has long been, regardless of the device, that it is good clinical practice to titrate the patient to their oxygen delivery system-- conserver or no conserver," said Joe Lewarski, vice president and general manager of Invacare's respiratory division. "It's important to note that if you go back to the long term oxygen consensus conferences over the years, that the same recommendation about titration and evaluation has been made about continuous flow."

In conducting the study, which was published Feb. 4 in the American Journal of Respiratory and Critical Care Medicine, researchers tested four of what they describe as the most widely used oxygen conservers on the market. They had 13 COPD patients use the conservers in random order, while at rest and during treadmill walking tests.

Their conclusion: "The mechanical and clinical performances of current oxygen conservers are highly variable and in some instances actually contribute to limitations in exercise ability. Seemingly equivalent technical features do not guarantee equivalent therapeutic functionality."

Len Serafino, vice president of sales at CHAD Therapeutics, a pioneer in oxygen conserving devices, said "we don't necessarily concur with their findings."

"When we go to a final design and test it out, we are confident that it will saturate most patients," he said. "Some patients are not good candidates, but there is almost always more than one way to do something."