Its not "failure" if they don't need oxygen during the day....sounds more like a sleep apnea issue so I would not query for chronic without oxygen 24/7
The way I view "resp failure" is if they were not on whatever oxygen they were on, would they be able to sustain adequate gas exchange. Since the pt does not require oxygen during the day, I would say it's not chronic resp failure.
just to throw this out here for discussion purposes- I worked with a pulmonologist that taught me that sleep apnea requiring CPAP at night did allow for the diagnosis of chronic respiratory failure. His rational was that respiratory failure is a disruption in the respiratory process- the passage of oxygen and CO2 gases in and out. an inability to maintain one's airway is failure. Sleep apnea is a chronic inability to maintain one's airway- (even if only at night). I had providers that would give me chronic respiratory failure based on this rational. It was not questioned by payers (but this was years ago). So using that rational, if oxygen is required at night to maintain oxygen levels then it may qualify for chronic respiratory failure. it might be worth a conversation with your providers about what constitutes chronic respiratory failure. I know this is not a commonly accepted definition but I do think sometimes thinking outside the box is a good exercise. Other clinical indicators to look for besides the traditional home oxygen criteria is polycythemia and of course a compensated acidosis.
Comments
Generally it's 24/7 usage.
Jeff
Its not "failure" if they don't need oxygen during the day....sounds more like a sleep apnea issue so I would not query for chronic without oxygen 24/7
The way I view "resp failure" is if they were not on whatever oxygen they were on, would they be able to sustain adequate gas exchange. Since the pt does not require oxygen during the day, I would say it's not chronic resp failure.
Hope that helps.
Dawn Valdez RN, LNC, CDIP, CCDS