Oxygen Administration Practices During Exercise Training In Ontario Pulmonary Rehabilitation Programs

RATIONALE: Individuals with moderate to severe lung disease may exhibit exertional hypoxemia that can limit exercise capacity. Oxygen may allow training at higher exercise intensities and durations, however, clinical practice guidelines for oxygen administration during exercise training in pulmonary rehabilitation (PR) are lacking. OBJECTIVE: To explore and describe clinical practices of oxygen administration in PR and facilitators and barriers to oxygen administration. METHODS: A 51-item web-based survey of health care professionals working in Ontario PR programs was conducted. PR programs were identified through an Ontario Lung Association database. MAIN RESULTS: Responses from 44/81 (54%) identified PR sites were obtained and a total of 56 eligible respondents from these sites initiated the survey resulting in 46 completed surveys and 10 partially completed surveys. Seventy-one percent of respondents reported oxygen administration protocols. Common practice was to maintain oxygen saturation above a specified level with exercise, which was managed by either administering oxygen or by stopping exercise. A prevalent perceived facilitator was knowledge regarding the benefits of oxygen during exercise, however half of the respondents reported they would not titrate oxygen in order to increase exercise training intensity or endurance capacity. The most common perceived barrier was oxygen administration outside professional scope of practice. CONCLUSIONS: Heterogeneity in oxygen administration practices exist in Ontario PR programs in regard to availability of oxygen protocols, professional training, authority to administer oxygen and methods for managing hypoxemia during exercise. The development of clinical guidelines around oxygen administration is warranted to facilitate exercise training and optimize functional outcomes during PR.