2022 Brazilian Thoracic Association recommendations for long-term home oxygen therapy

Abstract

Some chronic respiratory diseases can cause hypoxemia and, in such cases, long-term home oxygen therapy (LTOT) is indicated as a treatment option primarily to improve patient quality of life and life expectancy. Home oxygen has been used for more than 70 years, and support for LTOT is based on two studies from the 1980s that demonstrated that oxygen use improves survival in patients with COPD. There is evidence that LTOT has other beneficial effects such as improved cognitive function, improved exercise capacity, and reduced hospitalizations. LTOT is indicated in other respiratory diseases that cause hypoxemia, on the basis of the same criteria as those used for COPD. There has been an increase in the use of LTOT, probably because of increased life expectancy and a higher prevalence of chronic respiratory diseases, as well as greater availability of LTOT in the health care system. The first Brazilian Thoracic Association consensus statement on LTOT was published in 2000. Twenty-two years la-ter, we present this updated version. This document is a nonsystematic review of the literature, conducted by pulmonologists who evaluated scientific evidence and international guidelines on LTOT in the various diseases that cause hypoxemia and in specific situations (i.e., exercise, sleep, and air travel). These recommendations, produced with a view to clinical practice, contain several charts with information on indications for LTOT, oxygen sources, accessories, strategies for improved efficiency and effectiveness, and recommendations for the safe use of LTOT, as well as a LTOT prescribing model.

Efficacy of acupuncture as an adjunctive treatment to patients with stable COPD: a multicenter, randomized, sham-controlled trial protocol

“…Patients who meet any of the following conditions will be excluded: 1) combination of the severe cardiovascular, neurological, hematological, immune system, and malignant tumor diseases; 2) combined respiratory diseases that significantly impact the study (active tuberculosis, bronchial asthma, severe bronchiectasis, primary pulmonary hypertension, interstitial lung disease); 3) history of segmentectomy, wedge resection, lobectomy, total pneumonectomy, or lung volume reduction (including bronchoscopic lung volume reduction) for COPD; 4) continuous oxygen therapy is required according to long-term oxygen therapy (LTOT) criteria (oxygen therapy duration > 15 h/d) [ 29 ]; 5) unable to perform pulmonary function tests, unable to walk independently, unable to cooperate in completing questionnaires; 6) persistent breakage or infection of skin tissue at the needle site, coagulation dysfunction, skin allergy; 7) participated in another clinical trial or performed acupuncture for respiratory disease within the last 3 months; 8) pregnant and lactating women.…”