Domiciliary oxygen
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This document discusses the benefits and indications for long-term oxygen therapy in patients with chronic obstructive pulmonary disease (COPD). It notes that long-term oxygen therapy improves survival and quality of life by correlating survival with daily oxygen use duration. However, it can also cause adverse effects like cost, atelectasis, oxidative stress, and burns. The document provides guidelines for prescribing oxygen therapy based on oxygen saturation levels and other clinical factors. It recommends portable oxygen systems and exercising while using oxygen therapy.
![And thou wilt give thyself relief, if thou doest every act of thy life as if it were the last.
-Marcus Aurelius
If the patient meets criteria at rest, O2 should also be prescribed during sleep and exercise.
If the patient is normoxemic at rest but desaturates during exercise (PaO2≤55 mmHg [7.32
kPa]), O2 is generally prescribed for use during exercise
PRESCRIBING OXYGEN
● Determining need
● Oxygen flow rate
○ Threshold PaO2 or SpO2 that optimally improves survival and quality of life is not
known
○ TARGET PaO2 of 60 to 65 mmHg or an SpO2 of 90 to 92
● Equipment selection
○ portable or wearable oxygen systems PREFERRED
● Exercise training
- Created with love
by Dr. Eashan Srivastava](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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Domiciliary oxygen
- 1. And thou wilt give thyself relief, if thou doest every act of thy life as if it were the last. -Marcus Aurelius INTRODUCTION ● Increases survival and improves the quality of life of hypoxemic patients with COPD ● costly BENEFITS ● Improved survival ● Correlation between survival and the average daily duration of oxygen use ● Improved Quality of life, cardiovascular morbidity, depression, cognitive function, exercise capacity, and frequency of hospitalization ADVERSE EFFECTS ● Cost ● Absorptive atelectasis ● increased oxidative stress, inflammation ● Facial and upper airway burns INDICATIONS General indications PaO2≤55 mmHg or SaO2≤88 percent In the presence of cor pulmonale PaO2≤59 mmHg or SaO2≤89 percent EKG evidence of P pulmonale Hematocrit >55 percent Clinical evidence of right heart failure Specific situations OSA - Created with love by Dr. Eashan Srivastava
- 2. And thou wilt give thyself relief, if thou doest every act of thy life as if it were the last. -Marcus Aurelius If the patient meets criteria at rest, O2 should also be prescribed during sleep and exercise. If the patient is normoxemic at rest but desaturates during exercise (PaO2≤55 mmHg [7.32 kPa]), O2 is generally prescribed for use during exercise PRESCRIBING OXYGEN ● Determining need ● Oxygen flow rate ○ Threshold PaO2 or SpO2 that optimally improves survival and quality of life is not known ○ TARGET PaO2 of 60 to 65 mmHg or an SpO2 of 90 to 92 ● Equipment selection ○ portable or wearable oxygen systems PREFERRED ● Exercise training - Created with love by Dr. Eashan Srivastava