[Indications and costs of long-term oxygen therapy]

Nowadays, domiciliary long-term O2 therapy is given to certain patients with chronic arterial hypoxemia (PaO2 less than 55 mm Hg). However, it is important to exclude cases with severe CO2 retention (PaCO2 greater than 55 mm Hg). Hypoxemic and only slightly hypercapnic patients chiefly suffer from COLD and sometimes from a severe restrictive ventilatory disorder such as chronic bilateral pleural effusions or advanced kyphoscoliosis. The most important precondition for long-term O2 therapy is correct adjustment of all other procedures of pulmonary treatment, as well as total abstention from smoking. Common sources for domiciliary O2 therapy are bottles delivered to the patient's home weekly by the O2-producing firm. A new machine which appears to offer for greater facilities is the O2 concentrator of Rimer-Birlec (Cardiff, Wales). 2 liters O2/min are given via a naso-pharyngeal tube for 15 h per day. Without O2 during 9 h per day, the patient is able to follow appropriate employment. In domiciliary long-term O2 therapy the cost of O2 supply by the O2 concentrator is half that of bottles delivered to the home weekly. The new O2 concentrator for domiciliary long-term O2 therapy is recommended as by far the most economical source of O2. Other sources of O2 such as liquid O2 or chemically produced O2 are uneconomical for domiciliary use. Only hospitals will benefit from supplying their pipelines from a container with liquid oxygen instead of using gaseous O2 from bottles. The cost of the former is 3/4 that of the latter.