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CPD: Key Questions on domiciliary oxygen

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

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