User story: Oxygen titration during activity

Linette Marie Kofod is a physiotherapist based in Copenhagen, Denmark, specialising in respiratory physiotherapy and pulmonary rehabilitation. She is currently studying for a PhD at Örebro University in Sweden and continues to work in a clinical setting one day a week at Hvidovre Hospital in Copenhagen where she supports pulmonary rehabilitation patients, many of whom are on long-term oxygen treatment (LTOT).


“Improving oxygenation in the body is the primary goal for all respiratory physiotherapists. Dyspnea is one of the most debilitating symptoms experienced by patients with COPD, which can be relieved with exercise training in a routine that forms an essential part of pulmonary rehabilitation. During exercise, however, the amount of oxygen required by patients increases so even if they receive the same amount of oxygen required at rest, they desaturate, and their physical activity becomes limited by hypoxemia and dyspnea. We therefore recommend that supplementary oxygen is used during exercise for patients already on LTOT in pulmonary rehabilitation.”

“I first came into contact with O2matic [PRO 100] on the medical ward – it was new and it was being tested. I was intrigued because it seemed innovative to have oxygen adjusted continuously based on the saturation of the patient opposed to keeping a fixed flow. Initially we used it with patients with COPD exacerbation. We took it off the wall and placed it in the rollator and saw that it could be used in this portable way, which sparked the idea that maybe we could do something with patients with COPD in the rehabilitation centre when they were engaged in physical activity.”

“We decided to explore if using automated oxygen titration could be clinically relevant for patients with COPD, particularly those limited by their dyspnea. We wanted to understand how automated oxygen titration compared to usual fixed-dose oxygen treatment in patients on LTOT when it came to their endurance levels during exercise, so I based the first part of my PhD on this.”

“We assigned 33 patients with advanced COPT on LTOT to use either automated oxygen titration or the usual fixed-dose in a random order in a double-blinded randomised crossover trial. Both groups were asked to walk at the same speed for as long as they could. What we discovered is that when we used O2matic [PRO 100] to automatically adjust their oxygen, patients were able to walk for almost 100% longer compared to usual fixed-dose oxygen, and we were able to decrease their dyspnea by 50%.”

“It was exciting to see the notable difference that oxygen therapy tailored to an individual’s needs during walking had on these patients. It changed the whole way that I think about oxygen. It made me realize how important it is to monitor and continuously control saturation during exercise so that patients always have enough oxygen. I think automated oxygen titration is a promising way to effectively deliver that.”

“For most patients, if you ask them, ‘would you like to have two extra years or would you prefer an improved quality of life?’, they often choose quality of life. Being able to do more is definitely an important outcome for the patient. I think that regulating the oxygen flow automatically offers more opportunities for independent living in the future.”

“When I started the first part of my PhD, I wanted to know if it matters to patients that they become more oxygenated during exercise. With the use of automated oxygen titration, I discovered that it significantly did in terms of what they could achieve. I’m now curious to see how this mode of oxygen delivery might improve the quality of life of patients at home. This is where I will focus my research efforts next.

You can read the published study on Journal of Clinical Medicine. Linette will soon begin her next research project using O2matic HOT 100.