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Home Oxygen in Chronic Obstructive Pulmonary Disease
Yves Lacasse1, Ai-Yui M Tan2, François Maltais1
11 Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec, Québec, Canada; and.
American Journal of Respiratory and Critical Care Medicine
|March 17, 2018
Summary
Long-term oxygen therapy (LTOT) prolongs life for COPD patients with severe hypoxemia. However, evidence for other oxygen uses is limited, and adherence to LTOT is often poor.
Area of Science:
- Pulmonary Medicine
- Respiratory Therapy
Background:
- Landmark trials over 35 years ago established long-term oxygen therapy (LTOT) for specific chronic obstructive pulmonary disease (COPD) patients with severe hypoxemia.
- Indications for oxygen therapy have since expanded beyond proven life-prolonging uses.
Purpose of the Study:
- To review the evidence for various applications of supplemental oxygen therapy.
- To identify gaps in knowledge and areas for future research in oxygen therapy.
Main Methods:
- Review of landmark trials and subsequent randomized controlled trials (RCTs) of oxygen therapy.
- Analysis of the rationale and evidence supporting expanded indications for oxygen use.
Main Results:
- LTOT is proven to prolong life only in COPD patients with severe daytime hypoxemia.
- RCTs have generally failed to demonstrate significant clinical benefits for other oxygen therapy indications.
- Suboptimal adherence to LTOT is a common issue.
Conclusions:
- The evidence base for many uses of supplemental oxygen is weak.
- Further research is needed on mechanisms, predictors of response, adherence, and cost-effectiveness.
- Standardized terminology for home oxygen use is proposed.
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