Long-Term Oxygen Therapy in COPD Patients Who Do Not Meet the Actual Recommendations


Ergan B., Nava S.

COPD-JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, vol.14, no.3, pp.351-366, 2017 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 14 Issue: 3
  • Publication Date: 2017
  • Doi Number: 10.1080/15412555.2017.1319918
  • Journal Name: COPD-JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.351-366
  • Keywords: Chronic obstructive pulmonary disease, long-term oxygen, moderate hypoxemia, exercise, nocturnal, desaturation, OBSTRUCTIVE PULMONARY-DISEASE, QUALITY-OF-LIFE, 6-MIN WALK TEST, SUPPLEMENTAL OXYGEN, AMBULATORY OXYGEN, HOME OXYGEN, RESPIRATORY-FAILURE, DELIVERY DEVICES, THORACIC SOCIETY, RANDOMIZED-TRIAL
  • Dokuz Eylül University Affiliated: Yes

Abstract

Chronic respiratory failure due to chronic obstructive pulmonary disease (COPD) is an increasing problem worldwide. Many patients with severe COPD develop hypoxemic respiratory failure during the natural progression of disease. Long-term oxygen therapy (LTOT) is a well-established supportive treatment for COPD and has been shown to improve survival in patients who develop chronic hypoxemic respiratory failure. The degree of hypoxemia is severe when partial pressure of oxygen in arterial blood (PaO2) is 55 mmHg and moderate if PaO2 is between 56 and 69 mmHg. Although current guidelines consider LTOT only in patients with severe resting hypoxemia, many COPD patients with moderate to severe disease experience moderate hypoxemia at rest or during special circumstances, such as while sleeping or exercising. The efficacy of LTOT in these patients who do not meet the actual recommendations is still a matter of debate, and extensive research is still ongoing to understand the possible benefits of LTOT for survival and/or functional outcomes such as the sensation of dyspnea, exacerbation frequency, hospitalizations, exercise capacity, and quality of life. Despite its frequent use, the administration of "palliative" oxygen does not seem to improve dyspnea except for delivery with high-flow humidified oxygen. This narrative review will focus on current evidence for the effects of LTOT in the presence of moderate hypoxemia at rest, during sleep, or during exercise in COPD.