Oxygen therapy chronic obstructive pulmonary disease

In a patient with chronic respiratory acidosis (e.g., chronic obstructive pulmonary disease), treatment is essentially similar to that for acute respiratory acidosis with a few important exceptions. Oxygen therapy should be initiated carefully and only if the Pao2 is less than 50 mm Hg because the drive to breathe depends on hypoxemia rather than hypercarbia. 

Therapy is determined by the underlying cause. When the condition is secondary to hypoxia accompanying chronic obstructive pulmonary disease, long-term oxygen therapy improves symptoms and prognosis anticoagulation is essential when the cause is multiple pulmonary emboli. 

Continuous long-term domiciliary oxygen therapy (LTOT) is given to patients with severe persistent hypoxaemia and cor pulmonale due to chronic obstructive pulmonary disease (see later). Patients are provided with an oxygen... 

Poole P J, Black P N 2001 Oral mucolytic drugs for exacerbations of chronic obstructive pulmonary disease. British Medical Journal 322 1271-1274 Rees P J, Dudley F1998 Oxygen therapy in chronic lung disease. British Medical Journal 317 871-874 Rees P ], Dudley F1998 Provision of oxygen at home. 

M. F. Oliveira, M. K. Rodrigues,E. Treptow,T. M. Cunha, E. M. V. Ferreira,and J. A. Neder, Effects of Oxygen Supplementation on Cerebral Oxygenation diu-ing Exercise in Chronic Obstructive Pulmonary Disease Patients Not Entitled to Long-Term Oxygen Therapy, Clin. Physiol. Fund. Imaging, 32,52 (2012). 

Long-term oxygen-therapy is indicated for all patients with a stable chronic lung disease (such as chronic obstructive pulmonary disease, cystic fibrosis etc.), who have an arterial PO2 (oxygen partial pressure) consistently less than or equal to 55 mm Hg when breathing air, at rest and awake [10.2]. These patients need a... 

Abbreviations-. COPD, chronic obstructive pulmonary disease LTOT, long-term oxygen therapy ... 

Gay PC, Edmonds LC. Severe hypercapnia after low-flow oxygen therapy in patients with neuromuscular disease and diaphragmatic dysfunction. Mayo Clin Proc 1995 70 327-330. Mannino D. Chronic obstructive pulmonary disease in 2025 where are we headed Eur Respir J 2005 26 189. 

Figure 4 SGRQ scores in 14 patients with hypercapnic chronic obstructive pulmonary disease at baseline, after three months of oxygen therapy alone, and after three months of oxygen therapy plus NPSV. Deteriorated versus mn-in, p = 0.01, p = 0.03. Improved versus run-in, -f-p = 0.007. Improved versus oxygen alone, p = 0.03, p = 0.002, = 0.001. Abbreviations SGRQ, St. Geoige s Respiratray...

Nonoyama ML, Brooks D, Lacasse Y, et al. Oxygen therapy during exercise training in chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2007 (2) CD005372. 

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