CONSENSO ARGENTINO DE OXIGENOTERAPIA CRONICA DOMICILIARIA PDF

A national meeting of specialists in Respiratory Medicine took place with the aim of updating in a consensus the indicating criteria, source and ways of administering Long Term Oxygen Therapy LTOT. This is the only therapeutic intervention which improves the survival of patients with severe chronic obstructive pulmonary disease and respiratory insufficiency. Patients should receive this therapy more than 15 hours per day better 24 hours including sleeping time. Norms of study and indication were established to set up the requirements of O2 during sleep and exercise. With respect to the sources it was concluded that the O2 concentrator is indicated for patients with very little home movements, and the sources, of O2 liquid for those with active social life.

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No hay notas en la diapositiva. Se elaboraron normativas sobre los recursos para montar un programa. A group of pulmonologists and physical therapists from the Asociacion Argentina de Medicina Respiratoria revised the scientific literature on Respiratory Rehabilitation RR to elaborate evidence-based national recommendations to promote its use. RR is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and autonomy of patients.

Inclusion and exclu- sion criteria, guidelines for initial evaluation and follow up have been defined. The resources needed were defined. It was recommended a hospital ambulatory program with domiciliary complement. A pulmonologist and physical therapist were required for the program as minimum. Aerobic training was recommended for lower limb LL Evidence A and upper limb UL Evidence B , strength training for LL and UL Evidence C , as well as respiratory muscles training by resistive inspiratory threshold load Evidence D and other physi- otherapy techniques were recommended for specific patients.

In addition recommendations have been made for educational objectives of the program, nutritional and psychological support. The positive impact of RR on health care was analyzed through the reduction in exacerbation of COPD, length of hospital stay and cost.

This evidenced-based consensus statement was prepared to provide recommendations to be implemented nationally. Buenos Aires. Sobre encuestados, el Mejorar los costos de salud Evidencia A.

Han sido infor- miden la actividad en la vida diaria Un problema que ha ocu- te intervenir en un programa de RR3, 4, 27, Un cambio de 54 metros es lo que dos con distinto personal y hayan cotejado resultados. La sario todo este equipo multidisciplinario. La disnea se puede evaluar por la es- cial10, Por lo tanto la cantidad y calidad del personalcala de Borg o por la de Mahler20, Tam- tras que otros indican que no resultan suficientes30, Evidencia D 4, 6, 27, Esta efectividad es independiente del lugar en que psicosociales.

TABLA 1. Maltais y col. Sin embargo, Killian y del esfuerzo. Casaburi medida Respecto del tiempo, Frecuencia: 3 veces semanales. Requiere un circuito de re-respi-za en los miembros superiores e inferiores Evidencia C. Algunos estudios han de-del ejercicio, y a la hipercapnia75, Por el nos pacientes con EPOC cuando presentan disnea o au-contrario, con bajas cargas y muchas repeticiones se mento de la demanda ventilatoria.

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Medicina Buenos Aires Vol. Esta es la unica intervencion terapeutica que mejora la sobrevida en pacientes con enfermedad pulmonar obstructiva cronica EPOC severa e insuficiencia respiratoria. Se normatizo su indicacion en pacientes com EPOC, otras enfermedades obstructivas, enfermedades restrictivas, hipertension pulmonar primaria y secundaria con: 1 PaO2 inferior o igual a 55 mmHg respirando aire, en reposo; 2 PaO2 entre 56 y 60 mmHg con poliglobulia, cor pulmonale o hipertension pulmonar, evaluados en estabilidad clinica por dos muestras de gases en sangre arterial, con dos semanas de diferencia, o entre 1 y 3 meses post-reagudizacion respiratoria. Los pacientes deben recibir esta terapeutica mas de 15 horas por dia optimo 24 horas , incluyendo el periodo de sueno. Se establecieron las normas de estudio o indicacion para establecer los requerimientos de O2 durante el sueno y ejercicio. Con respecto a las fuentes se concluyo que el concentrador de O2 esta indicado para pacientes con limitada movilidad hogarena, y la fuente de O2 liquido para aquellos con activa vida social. Se establecieron las indicaciones de sistemas convencionales y no convencionales de administracion de O2.

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