Friday, December 27, 2019

Indications of long‐term oxygen therapy


I was discussing the indications of long‐term oxygen therapy with a friend today...

Long‐term continuous oxygen therapy, ideally for ≥18 h/day is indicated when:

1. Daytime partial arterial oxygen concentration (PaO2) is ≤ 55 mm Hg at rest or a pulse oxygen saturation (SpO2) less than or equal to 88 percent.

2. Daytime PaO2 is 56–59 mm Hg and there is evidence for hypoxic organ damage (right heart failure, pulmonary hypertension or polycythaemia)

Flow rate should be set to maintain PaO2 > 60 mm Hg (SpO2 > 90%) during waking rest.

Oxygen may be prescribed during exercise if there is a reduction of PaO2 to 55 mmHg or less, or of SpO2 to 88 percent or less during exercise.

Note: Survival benefit is seen in patients with more severe resting hypoxemia (arterial oxygen tension [PaO2] ≤60 mmHg. Patients with less severe hypoxemia may not derive survival benefit. It has been proven in patients with COPD but is often prescribed in patients with chronic lung disease.

Did you know? Follow-up at 3 months after oxygen therapy has been initiated is necessary to ensure it is still indicated.


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