Long term oxygen therapy

Introduction

• • Long term Oxygen Therapy (LTOT) refers to the provision of oxygen therapy for continuous use at home

  • For patients with chronic hypoxaemia (PaO2 at or below 7.3 kPa, (55mHg))

  • Oxygen flow rate must be sufficient to raise the waking oxygen tension above 8 kPa, (60 mmHg)

  • LTOT is likely to be life long

  • LTOT is usually given for at least 15 hours daily, to include night time

    • Often worsening arterial hypoxaemia during sleep

Indications

• • chronic hypoxaemia

    • long term oxygen therapy is indicated for the following conditions with chronic hypoxaemia:

      • chronic obstructive pulmonary disease

      • severe chronic asthma

      • interstitial lung disease

      • cystic fibrosis

      • bronchiectasis

      • pulmonary vascular disease

      • primary pulmonary hypertension

      • pulmonary malignancy

      • chronic heart failure

    • LTOT should usually be prescribed PaO2 is consistently at or below 7.3 kPa (55 mmHg) on air

    • level of PaCO2 (which may be normal or elevated) does not influence the need for LTOT prescription

  • nocturnal hypoventilation

    • obesity

    • Neuromuscular/spinal/chest wall disease

    • obstructive sleep apnoea (with CPAP therapy)

  • Palliative Use

    • Palliation of dyspnoea in pulmonary malignancy and other causes of disabling dyspnoea due to terminal disease