1. Idiopathic Pulmonary Fibrosis and Oxygen Therapy Louie Boitano, RCP Pulmonary Clinic University of Washington Medical Center

2. Effects of Idiopathic Pulmonary Fibrosis • Increases your work of breathing, by increasing elasticity of the lung tissue, causing shortness of breath with exertion. • Affects oxygenation of the blood by decreasing the movement of oxygen from the air you breathe into your lungs, through the alveolar membrane, and into the blood stream.

3. Effects of Decreased Blood Oxygenation • Further increases the work of breathing, causing increased shortness of breath, discomfort, anxiety and decreased activity. • Chronic decreased blood oxygenation has been shown to decrease life span by affecting your heart function.

4. Supplemental Oxygen Therapy • Support blood oxygenation >90% • Can decrease shortness of breath with activity and increase your level of activity . • Increase life span by decreasing the work of the heart and maintaining adequate oxygenation of the body tissues.

5. Determining The Need For Oxygen Therapy • Oximetry - a non-invasive means of measuring the percent of oxygen saturation in your blood. Can be measured while asleep, at rest and with exercise. • Arterial Blood Gas (ABG) - a sample of blood, usually taken from the artery of your wrist, is analyzed for oxygen content.

6. Supplemental Oxygen Therapy • An oxygen source provides a prescribed flow of oxygen gas measured in liters per minute. • Enriches the oxygen concentration of inhaled air to drive more oxygen into the blood. • Supplemental oxygen is considered a drug and should be prescribed according to the amount necessary to maintain the blood oxygen level > 90%.

7. Oxygen Therapy Systems • Oxygen Concentrators: separate nitrogen from the air, providing oxygen at a concentration of approximately 94- 96% • Provide 1-5 liters/minute • Beneficial for night time oxygen support and daytime support within the home. • Electricity dependent; requires backup source.

8. Oxygen Therapy Systems • Continuous Flow Compressed Gas Oxygen: Usually provides 1-10 liters/minute. • Portable but not convenient; bulky cylinders. • Portable E cylinders provide only a short period of support, 2-3 hours @ 2 lpm. • Require significant storage space in the home.

9. Oxygen Therapy Systems • Portable pulse dose oxygen (liquid or gas O2) : provides 1-6 liters/min. • Most portable and convenient supply. • Conserves the O2 supply and provides the longest period of support. • Limited support due to the speed of pulse dose response in relation to a person’s breath rate.

10. Oxygen Therapy Systems • Continuous flow liquid oxygen: Provides 1-6 liters/min. • Highest oxygen support in smallest containment when used with reservoir nasal cannula systems. • Best high flow support system with progressively decreasing blood oxygenation, and when pulse dose O2 is no longer supportive.

11. Supplemental Oxygen Therapy • Can improve your quality of life by decreasing shortness of breath with activity, and maintain an improved level of activity. • Can increase your life span by decreasing the work of the heart. • Can provide support for travel and travel related activities.