Community Physician-Guided Long-Term Domiciliary Oxygen Therapy Combined With Conventional Therapy in Stage IV COPD Patients

Bao, Hong; Wang, Jiaman; Zhou, Ding; Han, Zhaoyong; Zhang, Yuan; Su, Ling; Xiong, Ye; Xu, Chunyan; Fu, Meihong; Li, Qinghua

doi:10.1002/rnj.233

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Overall, it remains unclear whether LTOT reduces healthcare use. One retrospective study [ 33 ] found fewer hospitalisations over 3 years in the LTOT group compared with conventional therapy (mean difference: −1.17, 95% CI −1.73–−0.59), whereas an observational study could not confirm that finding [ 34 ].…”

Section: Copd and Hypoxaemic Respiratory Failurementioning

confidence: 99%

Supplemental oxygen and noninvasive ventilation

2023

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The respiratory system attempts to maintain normal levels of oxygen and carbon dioxide. However, airflow limitation, parenchymal abnormalities and dysfunction of the respiratory pump may be compromised in individuals with advanced COPD, eventually leading to respiratory failure, with reduced arterial oxygen tension (hypoxaemia) and/or increased arterial carbon dioxide tension (PaCO2; hypercapnia). Hypoxaemia may persist in individuals with severe COPD despite smoking cessation and optimisation of pharmacotherapy. Long-term oxygen therapy (LTOT) can improve survival in those with severe daytime hypoxaemia, whereas those with less severe hypoxaemia may only have improved exercise capacity and dyspnoea. Changes in respiratory physiology that occur during sleep further predispose to hypoxaemia, particularly in individuals with COPD. However, the major cause of hypoxaemia is hypoventilation. Noninvasive ventilation (NIV) may reduce mortality and need for intubation in individuals with COPD and acute hypercapnic respiratory failure. However, NIV may also improve survival and quality of life in individuals with stable, chronic hypercapnia and is now suggested for those with prolonged hypercapnia (e.g.PaCO2>55 mmHg 2–6 weeks after hospital discharge) when clinically stable and after optimisation of medical therapy including LTOT if indicated. Many questions remain about the optimal mode, settings and goal of NIV therapy.

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Section: Copd and Hypoxaemic Respiratory Failurementioning

confidence: 99%

Supplemental oxygen and noninvasive ventilation

2023

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Home Oxygen Therapy for Adults with Chronic Lung Disease. An Official American Thoracic Society Clinical Practice Guideline

Jacobs

Krishnan

Lederer

et al. 2020

Am J Respir Crit Care Med

162

139

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Background: Evidence-based guidelines are needed for effective delivery of home oxygen therapy to appropriate patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). Methods: The multidisciplinary panel created six research questions using a modified Delphi approach. A systematic review of the literature was completed, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to formulate clinical recommendations. Recommendations: The panel found varying quality and availability of evidence and made the following judgments: 1 ) strong recommendations for long-term oxygen use in patients with COPD (moderate-quality evidence) or ILD (low-quality evidence) with severe chronic resting hypoxemia, 2 ) a conditional recommendation against long-term oxygen use in patients with COPD with moderate chronic resting hypoxemia, 3 ) conditional recommendations for ambulatory oxygen use in patients with COPD (moderate-quality evidence) or ILD (low-quality evidence) with severe exertional hypoxemia, 4 ) a conditional recommendation for ambulatory liquid-oxygen use in patients who are mobile outside the home and require >3 L/min of continuous-flow oxygen during exertion (very-low-quality evidence), and 5 ) a recommendation that patients and their caregivers receive education on oxygen equipment and safety (best-practice statement). Conclusions: These guidelines provide the basis for evidence-based use of home oxygen therapy in adults with COPD or ILD but also highlight the need for additional research to guide clinical practice.

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Community Physician-Guided Long-Term Domiciliary Oxygen Therapy Combined With Conventional Therapy in Stage IV COPD Patients

Abstract: Rehabilitation nurses can be instrumental in helping patients with stage IV COPD learn principles of LTDOT.

Cited by 2 publications

References 14 publications

Supplemental oxygen and noninvasive ventilation

Supplemental oxygen and noninvasive ventilation

Home Oxygen Therapy for Adults with Chronic Lung Disease. An Official American Thoracic Society Clinical Practice Guideline

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