Wayne State University

WSU researcher receives Blue Cross Blue Shield of Michigan Foundation grant to determine benefits of administering oxygen to end-of-life patients

Margaret L. Campbell

DETROIT– Margaret L. Campbell, Ph.D., R.N., assistant professor of nursing in the Wayne State University College of Nursing and resident of Detroit, received $73,784 from the Blue Cross Blue Shield of Michigan Foundation to determine the benefit of routine oxygen administration to terminally ill patients who are near death.

Oxygen administration can be beneficial for making terminally ill patients who are experiencing shortness of breath – known as dyspnea – more comfortable. As patients approach death, however, changes in cognition and consciousness make it difficult to determine whether dyspnea is occurring. Applying oxygen to patients who are no longer responsive is the current standard; however, it is not clear if this practice is beneficial.

Campbell’s study, which will work to shed light on the usefulness of this practice, stemmed from her own bedside experience with patients. “Nurses are often left guessing as to how to treat patients once they can no longer communicate with us,” she said. “Oxygen administration could prolong natural dying, even making patients uncomfortable – we don’t know.” Campbell said. “For these reasons, there is an urgent need to determine whether oxygen at the end of life serves a beneficial purpose or if it increases suffering.”

Using an observation scale of Campbell’s design, respiratory distress signs will be measured in patients as weighted, objective variables. These signs, which include rapid breathing, increased heart rate and increased use of chest and abdomen muscles, will be recorded when patients breathe room air, medical air or oxygen. Any changes in respiratory distress signs will suggest whether oxygen administration is making a difference in patients’ breathing ability and general comfort level, suggesting whether the effect is positive or negative. Oxygen will not be withheld as part of the study but rather measured according to physicians’ orders.

“Past studies on the benefits of oxygen administration have almost always excluded near-death patients,” Campbell said. “It will be incredibly valuable to have more information indicating whether this practice is really helping patients be more comfortable at the end of their lives.”

“Blue Cross Blue Shield is committed to research that will educate physicians on the best possible patient care,” said Ira Strumwasser, executive director and CEO of the Blue Cross Blue Shield of Michigan Foundation. “In determining whether oxygen administration increases patients’ comfort levels or causes unnecessary distress, we will significantly increase our understanding of patient needs and, if necessary, reshape physician practices to meet those needs with the purpose of improving the quality of patient care.”

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Wayne State University is one of the nation’s pre-eminent public research universities in an urban setting. Through its multidisciplinary approach to research and education, and its ongoing collaboration with government, industry and other institutions, the university seeks to enhance economic growth and improve the quality of life in the city of Detroit, state of Michigan and throughout the world. For more information on research at Wayne State University, visit http://www.research.wayne.edu.