An On-Demand Oxygen Flow Meter for Enhanced Patient Comfort and Reduced Oxygen Cost in Hospitals.

Background: Hypoxemia is currently treated in hospital wards with oxygen, released continuously by "conventional" flow meters. A new type of hybrid flow meter allows to switch between on-demand and continuous mode. The aim of this observational study was to assess whether this new device reduces oxygen expenditure, is well accepted in a hospital setting and improves patient comfort during oxygen therapy. Methods: Oxygen was administered in hypoxemic patients with conventional or hybrid flow meters to maintain an oxygen saturation of ≥ 92% over a 12-week period. Every two weeks conventional and hybrid flow meters were switched. The overall oxygen delivery to the ward was continuously measured with a data logging device installed in the main oxygen pipeline and corrected for multiple confounding factors. Humidity measurements, for which a sensor placed in front of one of the nostrils, and patient questionnaires, were used to assess patient comfort during continuous and on-demand flow. Results: Overall oxygen delivery decreased by 39% when switching from continuous flow to on-demand therapy after correction for confounding factors. Continuous flows significantly decreased relative humidity more than equivalent on-demand settings and the latter tended to increase comfort. Conclusions: Hybrid flow meters cause a significant reduction in oxygen delivery in a hospital ward, which may lead to financial savings. Using the on-demand technology also lowers the dryness of the upper airways (and may increase patient comfort), while maintaining an adequate oxygenation.

Sarcoidosis following Mycobacterium tuberculosis infection: Coincidence or consequence.

We describe the case of a 47-year-old Caucasian male patient who developed sarcoidosis 18 months after he was diagnosed with pulmonary tuberculosis for which he was treated according to guidelines. The presentation of sarcoidosis was very similar to his first presentation when he was diagnosed with tuberculosis. Mycobacterium tuberculosis as a possible aetiological agent in sarcoidosis has been point of debate since many years and has been studied thoroughly. Recent advances in immunologic and molecular techniques have strengthened the association between mycobacteria and sarcoidosis.(1) Sarcoidosis is a systemic inflammatory disorder of unknown aetiology, characterised by the presence of non-caseating epitheloid cell granulomas. It is generally agreed that this is a tissue reaction to environmental agents in a genetically susceptible individual.(2) Tuberculosis is an infectious disease caused by M. tuberculosis and characterised by caseating granulomas. In both clinical and histopathological features sarcoidosis is remarkably similar to tuberculosis and therefore can be difficult to distinguish. First, this case report demonstrates the need of diagnostic testing when reactivation of tuberculosis is suspected. And second the role of M. tuberculosis in the aetiology of sarcoidosis will be discussed.