Titrated oxygen requirement and prognostication in idiopathic pulmonary fibrosis

Eur Respir J. 2012 Feb;39(2):359-65. doi: 10.1183/09031936.00108111. Epub 2011 Sep 1.


The supplemental oxygen flow rate is a common bedside measure of gas exchange impairment. We aimed to determine whether a titrated oxygen requirement (TOR) predicted mortality in idiopathic pulmonary fibrosis (IPF). We examined 104 adults with IPF enrolled in a prospective cohort study and a validation cohort of 151 adults with a variety of interstitial lung diseases (ILDs). The TOR was defined as the lowest oxygen flow rate required to maintain an oxyhaemoglobin saturation of 96% while standing. Cox proportional hazards models and time-dependent receiver operating characteristic curves were used to examine survival time. A higher TOR was associated with a greater mortality rate independent of forced vital capacity and 6-min walk test results in IPF (adjusted hazard ratio (per 1 L·min(-1)) 1.16, 95% CI 1.06-1.27). The TOR was at least as accurate as pulmonary function and 6-min walk testing at predicting 1-yr mortality. Findings were similar in other ILDs. The TOR is a simple, inexpensive bedside measurement that aids prognostication in IPF.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Aged
  • Female
  • Humans
  • Idiopathic Pulmonary Fibrosis / mortality*
  • Idiopathic Pulmonary Fibrosis / physiopathology
  • Idiopathic Pulmonary Fibrosis / therapy*
  • Lung Diseases, Interstitial / mortality
  • Lung Diseases, Interstitial / physiopathology
  • Lung Diseases, Interstitial / therapy
  • Male
  • Middle Aged
  • Oxygen Inhalation Therapy / methods*
  • Oxygen Inhalation Therapy / mortality*
  • Oxygen Inhalation Therapy / standards
  • Physical Endurance / physiology
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Pulmonary Gas Exchange / physiology
  • Reproducibility of Results
  • Risk Factors
  • Severity of Illness Index*
  • Treatment Outcome
  • Vital Capacity / physiology
  • Walking