Rationale for prescribing supplemental oxygen during exercise training Supplemental oxygen during exercise training in people with COPD: a survey Leung R1, McKeough Z1, McDonald C2, Jenkins S3, Holland A4,5, Hill K6, Morris N7, Hill C2, Lee A4, Cecins N3, Seale H7, Spencer L8, Alison J1 1Physiotherapy, The University of Sydney, Sydney, Australia; 2Respiratory and Sleep Medicine, Austin Health, Melbourne, Australia; 3Physiotherapy, Sir Charles Gairdner Hospital, Perth, Australia; 4Physiotherapy, Alfred Health, Melbourne, Australia; 5Physiotherapy, La Trobe University, Melbourne, Australia; 6Physiotherapy and Exercise Science, Curtin University, Perth, Australia; 7Physiotherapy, The Prince Charles Hospital, Brisbane, Australia and 8Physiotherapy, Royal Prince Alfred Hospital, Sydney, Australia Exercise-induced desaturation, which is often defined as a drop of >4% in oxygen saturation (SpO2) to < 90%, is common1,2 in people with moderate to severe COPD during exercise assessment. Provision of supplemental oxygen during exercise training in pulmonary rehabilitation for people with COPD who demonstrate exercise-induced desaturation, is recommended3. Although supplemental oxygen is commonly used in pulmonary rehabilitation, little is known about the provision of supplemental oxygen during exercise training in pulmonary rehabilitation for people with COPD in clinical practice. Introduction Results 265 programs were emailed and 128 surveys were completed (48.3%) including 7 surveys which were partially completed (preliminary data) Occupation of responders Experience of responders Program settings (Some programs are running at more than one site) Program size Provision of supplemental oxygen therapy during exercise training Majority of the surveyed PRPs (99%) provided an exercise training component. 83% of programs had supplemental oxygen available but only 36% of them had a specific protocol for using supplemental oxygen during exercise training. For programs with supplemental oxygen, the majority (95%) delivered oxygen via portable oxygen cylinder, mainly at the flow of 2L/min (67% of programs). For programs without supplemental oxygen (17%), 59% were community programs and more than half of them had 20-50 participants per year. Protocol for the provision of supplemental oxygen during exercise training in PRPs in Australia Protocols varied greatly between programs. Patients on long-term oxygen therapy (LTOT) continued following the prescription during exercise training. For patients not on LTOT, most protocols stated that supplemental oxygen was provided if SpO2 dropped below 85-88% during activities, usually after a review by the general practitioners or respiratory physicians. A few programs stated that arterial blood gases would be examined before prescribing supplemental oxygen during exercise training. Determinants of oxygen therapy prescription during exercise training in PRPs Results Rationale for prescribing supplemental oxygen during exercise training (more than one answer could be provided) For those programs that chose ‘keeping SpO2 over a threshold’, the majority of them aim to keep the SpO2 over 85% percentage *EP: exercise physiologist Supplemental oxygen is available during exercise training in most PRPs in Australia. Although supplemental oxygen is commonly available, the protocol for prescribing oxygen during training varies across programs and has not been standardised. Furthermore, the rationale for prescribing supplemental oxygen during exercise training in people with COPD also varies across programs. A standardised protocol for prescribing supplemental oxygen during exercise training in PRPs is recommended. More evidence is needed for the benefit of using supplemental oxygen during exercise training, especially in people with COPD who demonstrate exercise-induced desaturation. Conclusion Percentage To investigate the pattern of prescribing supplemental oxygen and the rationale for using supplemental oxygen during exercise training in pulmonary rehabilitation programs (PRPs) in Australia Aim Participants Coordinators of PRPs listed on the Lung Foundation Australia’s database Participants were invited to complete a purpose-designed anonymous online survey via email. Ethics approval was granted and consent was implied if surveys were completed and returned. Trial registration: ACTRN12616000813482 Method Number o f participants per year Percentage References & Acknowledgements 1. van Gestel AJ et al (2012). Respiration, 84: 353–359. 2. Jenkins et al (2011). Intern Med J, 41 (5): 416-22. 3. Holland et al (2014). ERJ, 44(6): 1428-46 Special thanks to all participants who have completed the survey. please contact Dr Regina Leung (regina.leung@sydney.edu.au) for more information of the study (more than one answer could be provided)