Treatment Overview
Oxygen treatment increases the amount of
oxygen that flows into your lungs and bloodstream. If your COPD is very bad and
your blood oxygen levels are low, getting more oxygen can help you breathe
better and live longer.
There are several
ways to deliver the oxygen, including:
- Oxygen concentrators.
- Oxygen-gas
cylinders.
- Liquid-oxygen devices.
You don't have to stay at home or in a hospital to use
oxygen. Oxygen systems are portable. You can use them while you do your daily
tasks.
What To Expect After Treatment
Long-term oxygen treatment may improve
your quality of life. It can help you live longer when you have severe COPD and
low oxygen levels.
You may notice less shortness of breath and have more energy.
Why It Is Done
Long-term oxygen therapy is used for
COPD if you have low levels of oxygen in your blood (hypoxia). It is used
mostly to slow or prevent right-sided
heart failure. It can help you live longer.
Oxygen may be given in a hospital if you have a rapid, sometimes sudden,
increased shortness of breath (COPD exacerbation). Oxygen can also be
used at home if the oxygen level in your blood is too low for long
periods.
Long-term oxygen therapy should be used for at least 15
hours a day with as few interruptions as possible. Regular use can reduce the
risk of death from low oxygen levels.2 To get the most
benefit from oxygen, you use it 24 hours a day.
An
arterial blood gas test should be done first to see if
you need oxygen. You may not be able to get Medicare reimbursement for home
oxygen therapy without this test. If your test results do not meet the
following guidelines, Medicare may not pay for home oxygen therapy:
- Arterial
partial pressure of oxygen (PaO2) is less than or
equal to 55 mm Hg (millimeters of mercury, a measure of
pressure).
- Arterial oxygen saturation is less than or equal to
88%.
- Arterial partial pressure of oxygen (PaO2) is between 56 mm Hg
and 59 mm Hg, or oxygen saturation is 89% and you have:
- Evidence of right-side heart failure due to
breathing problems (cor pulmonale).
- Heart failure.
- An increased number of red
blood cells (erythrocytosis).
- Arterial oxygen saturation is greater than 88%
when you are resting but becomes less than or equal to 88% when you are
exercising or sleeping.
How Well It Works
Several studies show that using
oxygen at home for more than 15 hours a day increases quality of life and helps
people live longer when they have severe COPD and low blood levels of
oxygen.2, 3 Oxygen therapy has good short-term and long-term effects in people with COPD.1
Using
oxygen may also improve confusion and memory problems. It may improve impaired
kidney function caused by low oxygen levels.
Risks
Generally, there are no risks from oxygen
treatment as long as you follow your doctor's instructions. But oxygen is a
fire hazard, so it is important to follow safety rules. Do not use oxygen
around lit cigarettes, open flames, or anything flammable.
Oxygen
is usually prescribed to raise the PaO2 to between 60 and 65 mm Hg or the
saturations from 90% to 92%. Higher flow rates usually do not help, and they
can even be dangerous.
What To Think About
People using oxygen should not
smoke.
Do not use oxygen around lit cigarettes or an open flame.
If you or those who care for you smoke, or if there are other risks for fire,
it is important to consider oxygen treatment very carefully because of the
danger of fire or explosion.
You may need oxygen in certain
situations, including:
- During exercise. For
some people with COPD, blood oxygen levels drop only when they exercise or are
very active. Using oxygen during exercise may help boost performance and reduce
shortness of breath for some people. But there are no studies that show any
long-term benefits from using oxygen during exercise.
- During sleep. During sleep, breathing naturally slows
down because the body doesn't need as much oxygen. Sleep-related breathing
disorders are quite common in people with COPD, and many will have
significantly low blood oxygen levels during sleep.
- For air travel. The level of oxygen in airplanes is about the
same as the oxygen level at an elevation of
8000 ft (2438 m). This drop
in oxygen can really affect people with COPD. If you normally use oxygen or
have borderline-low oxygen levels in your blood, you may need oxygen when you
fly. Traveling with oxygen usually is possible. But it is
important to plan ahead before you travel.
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
References
Citations
- Kim V, et al. (2008). Oxygen therapy in chronic obstructive pulmonary disease. Proceedings of the American Thoracic Society, 5(4): 513–518.
- Kerstjens H, et al. (2005). Chronic
obstructive pulmonary disease. Clinical Evidence (13):
1923-1947.
- Global Initiative for Chronic Obstructive
Lung Disease (GOLD) (2005). Executive summary (updated 2005). In
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Available online:
http://www.goldcopd.com/GuidelinesResources.asp?I1=2&I2=0.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Caroline S. Rhoads, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Ken Y. Yoneda, MD - Pulmonology |
|---|
| Last Revised | May 4, 2010 |
|---|
Kim V, et al. (2008). Oxygen therapy in chronic obstructive pulmonary disease. Proceedings of the American Thoracic Society, 5(4): 513–518.
Kerstjens H, et al. (2005). Chronic
obstructive pulmonary disease. Clinical Evidence (13):
1923-1947.
Global Initiative for Chronic Obstructive
Lung Disease (GOLD) (2005). Executive summary (updated 2005). In
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Available online:
http://www.goldcopd.com/GuidelinesResources.asp?I1=2&I2=0.
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