Home Oxygen Therapy for Adults with Chronic Lung Disease
Publication Date: August 31, 2020
Last Updated: January 19, 2024
Recommendations
Chronic Obstructive Pulmonary Disease
In adults with chronic obstructive pulmonary disease (COPD) who have severe chronic resting room air hypoxemia,* we recommend prescribing long-term oxygen therapy (LTOT) for at least 15 h/d. (S, M)
*Severe hypoxemia is defined as meeting either of the following criteria: 1) PaO2 ≤ 55 mm Hg (7.3 kPa) or oxygen saturation as measured by pulse oximetry (SpO2) ≤ 88%; 2) PaO2 = 56–59 mm Hg (7.5–7.9 kPa) or SpO2 = 89% plus one of the following: edema, hematocrit ≥ 55%, or P pulmonale on an ECG.
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In adults with COPD who have moderate chronic resting room air hypoxemia,* we suggest not prescribing LTOT. (C, L)
*Moderate hypoxemia is defined as an SpO2 of 89–93%.
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In adults with COPD who have severe exertional room air hypoxemia, we suggest prescribing ambulatory oxygen. (C, M)
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Interstitial Lung Disease
For adults with interstitial lung disease (ILD) who have severe chronic resting room air hypoxemia, we recommend prescribing LTOT for at least 15 h/d. (S, VL)
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For adults with ILD who have severe exertional room air hypoxemia, we suggest prescribing ambulatory oxygen. (C, L)
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Liquid Oxygen
In patients with chronic lung disease who are mobile outside of the home and require continuous oxygen flow rates of >3 L/min during exertion, we suggest prescribing portable liquid oxygen (LOX). (C, VL)
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Education and Safety
For patients prescribed home oxygen therapy, we recommend that the patient and their caregivers receive instruction and training on the use and maintenance of all oxygen equipment and education on oxygen safety, including smoking cessation, fire prevention, and tripping hazards. (, )
(best-practice statement)
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Recommendation Grading
Overview
Title
Home Oxygen Therapy for Adults with Chronic Lung Disease
Authoring Organization
American Thoracic Society
Publication Month/Year
August 31, 2020
Last Updated Month/Year
February 15, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Male, Female, Adult
Health Care Settings
Ambulatory, Long term care
Intended Users
Nurse, nurse practitioner, physician, physician assistant, social worker
Scope
Assessment and screening
Diseases/Conditions (MeSH)
D017563 - Lung Diseases, Interstitial, D029424 - Pulmonary Disease, Chronic Obstructive
Keywords
hypoxemia, interstitial lung disease, chronic obstructive pulmonary disease (COPD), immobility, pulmonary disease, quality of life