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. Accessed, RESUME Introduction : L'oxygénothérapie pulsé consiste à administrer de l'oxygène lors de l'effort inspiratoire du patient et permet d'éviter le gaspillage d'oxygène lors de la phase expiratoire. Ils sont de plus en plus utilisés chez les patients BPCO au stade d'insuffisance respiratoire chronique mais les données des différentes études sont contradictoires avec des populations généralement de faible effectif. Par ailleurs, aucune étude n'a comparé les performances des différents systèmes disponibles. Enfin, il n'existe pas de caractéristiques identifiées permettant de prédire l'échec d'une oxygénothérapie pulsée. Notre objectif principal était de comparer les performances des concentrateurs utilisé en mode pulsé chez des patients atteints de BPCO comparativement à l'oxygénothérapie continue, 2020.

, randomisée en cross-over multicentrique incluant 19 centres français promue par l'ANTADIR. Chaque patient réalisait un test de marche avec un dispositif d'oxygénothérapie continu et un test de marche avec un dispositif d'oxygène pulsé dans un ordre randomisé. Nous avons relevé pour chaque test de marche la saturation de fin de test, la fréquence cardiaque, la dyspnée par l'échelle de BORG, la distance parcourue, le nombre de minutes avec une saturation <90% ainsi que la saturation, Méthodes : Nous avons réalisé une étude de non-infériorité contrôlée, en ouvert

, La comparaison des performances des différents concentrateurs ne montrait pas de différence significative dans le changement de la distance parcourue, celui de dyspnée de fin de test, celui de la fréquence cardiaque maximale et celui du nombre d'arrêts au cours du test de marche mais il existait des différences significatives entre les différents concentrateurs relativement à l'oxygénation évaluée par la saturation de fin de test (p=0,005) le temps passé sous une saturation < 90%(p=0,002) et le nadir de saturation(p=0,0003). Les patients parcourant une distance moindre avec l'oxygène pulsé avaient un rapport VEMS/CVF plus important que ceux n'étant pas en échec, aucune caractéristique ne permettait de distinguer une dyspnée plus importante avec l'oxygène pulsé, les patients ayant une moins bonne oxygénation avec l'oxygène pulsé avaient un VEMS et une CVF plus bas que ceux n, Résultats : Un total de 234 a été évalué pour son éligibilité à l'étude et 208 ont été inclus entre décembre 2011 et février 2019. Leur âge était de 65±9 ans et 119 (57%) étaient de sexe masculin

, les concentrateurs d'oxygène pulsé n'altéraient pas les performances à la marche des patients atteints de BPCO comparativement à l'oxygénothérapie continue. Cependant, les différents concentrateurs pulsés n'avaient pas les mêmes performances relativement au maintien de la saturation des patients au cours du test de marche. Nous avons illustré à l'échelle individuelle que l'efficacité des systèmes d'oxygénothérapie pulsée était variable. Enfin, nous avons identifié des critères associés à un échec de ces modes pulsés : la proportion de cycles déclenchés, Discussion : Nous avons montré que, dans leur ensemble