Home Oxygen Therapy for Adults with Chronic Lung Disease

Publication Date: September 1, 2020

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

Disclaimer

Overview

Title

Home Oxygen Therapy for Adults with Chronic Lung Disease

Authoring Organization

Publication Month/Year

September 1, 2020

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Male, Adult

Health Care Settings

Ambulatory, Long term care

Intended Users

Social worker, physician, nurse, nurse practitioner, physician assistant

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

Supplemental Methodology Resources

Data Supplement, Data Supplement, Data Supplement