• Titrate When You Migrate!
  • November 2006
    PEP Pioneers
    Second Wind
    Torrance, California
  • Dear Friends

    Titrate or titration means measuring something in increments or continuously. This is important in active patients who receive oxygen.

    The availability of increasing numbers of portable and truly ambulatory, i.e., wearable oxygen devices is a major advance in the mobility and quality of life for many patients. But these new developments require some checking to see if they put out enough oxygen for all patients, under varying circumstances.

    Oxygen conserving devices give a different pulse or bolus of oxygen with each breath depending on the manufacturer. These are not the same between the liquid, small compressed cylinders, and portable oxygen concentrators. Many of these put out less than one total liter a minute. Others put out more. One device or setting is not appropriate for all patients. No simple prescriptions can cover all possibilities.

    Here is where titration comes in. Small, inexpensive, and accurate oximeters are available to test the results of oxygen settings and various liter flows. The settings on the conserving devices are NOT liter flows, but so-called "flow equivalents." These have been determined in a laboratory. You are the only one who can tell what your oxygenation is at what setting of your system. So learn to titrate your oxygen flows and settings to be sure your saturation is above 90% when active, as is walking or playing. Use your oximeter on airplanes and when driving in the mountains.

    Ask your doctor to prescribe an oximeter for you if you are active. Most insurance companies will reimburse the approximate $300 cost.

    You will feel better and have more fun if you titrate when you migrate. Another way to put it is "measure while you pleasure!"

    I will be in touch next month.

    Your friend,
  • Thomas Petty, MD