CPD: Key Questions on domiciliary oxygen

Key learning points

Domiciliary oxygen can be for both symptomatic and prognostic purposes – LTOT improves survival in patients with COPD
Oxygen can be supplied by concentrator, gas or liquid cylinder, and delivered by mask or nasal cannula
Oxygen is not indicated for patients with cardiopulmonary disease with dyspnoea who maintain saturations greater than 91%, or who will not comply with the prescribed number of hours per day
Patients with respiratory problems planning to travel by air should receive in-flight oxygen if their resting saturations are less than 92%

Dr Roger Henderson is a GP and UK medical director for @LIVAHealthcare

Q. Which patients with COPD should we refer for consideration of domiciliary oxygen – and is the treatment for symptomatic or prognostic purposes?

Treatment can be for both symptomatic and prognostic reasons. The NICE clinical guideline for COPD¹ recommends referring for long-term oxygen therapy (LTOT) assessment if the patient has an oxygen saturation of 92% or less breathing air. NICE also recommends LTOT if airflow obstruction is very severe (FEV1 less than 30% predicted) or severe (FEV1 30-49% predicted), or the patient has cyanosis, polycythaemia, peripheral oedema or raised jugular venous pressure. Long-term administration of oxygen (usually at least 15 hours daily) improves survival in patients with severe COPD.²