COPD Oxygen therapy
Oxygen therapy is a treatment that provides you with supplemental, or extra, oxygen. Although oxygen therapy may be common in the hospital, it can also be used at home. There are several devices used to deliver oxygen at home. Your healthcare provider will help you choose the equipment that works best for you. Oxygen is usually delivered through nasal prongs (an oxygen cannula) or a face mask. Oxygen equipment can attach to other medical equipment such as CPAP machines and ventilators.
Oxygen therapy can help you feel better and stay active. Learning all you can about oxygen therapy can help you feel more comfortable and confident.
Long-term oxygen therapy
If COPD causes a low level of oxygen in your blood, you may be advised to have oxygen at home through nasal tubes or a mask.
This can help stop the level of oxygen in your blood becoming dangerously low, although it’s not a treatment for the main symptoms of COPD, such as breathlessness.
Long-term oxygen treatment should be used for at least 16 hours a day.
The tubes from the machine are long, so you will be able to move around your home while you’re connected. Portable oxygen tanks are available if you need to use oxygen away from home.
Do not smoke when using oxygen. The increased level of oxygen is highly flammable and a lit cigarette could cause a fire or explosion.
Long-term oxygen therapy
If COPD causes a low level of oxygen in your blood, you may be advised to have oxygen at home through nasal tubes or a mask.
This can help stop the level of oxygen in your blood becoming dangerously low, although it’s not a treatment for the main symptoms of COPD, such as breathlessness.
Long-term oxygen treatment should be used for at least 16 hours a day.
The tubes from the machine are long, so you will be able to move around your home while you’re connected. Portable oxygen tanks are available if you need to use oxygen away from home.
Do not smoke when using oxygen. The increased level of oxygen is highly flammable and a lit cigarette could cause a fire or explosion.
1 Oxygen concentrators
Home concentrator
This machine concentrates oxygen by filtering the nitrogen out of the air and is the most common method of oxygen delivery for people on long-term oxygen. It has a long tube that allows you to move more freely around the house and requires electricity to operate.
Portable concentrator
This is a smaller concentrator designed to be taken out of the home. Many are so light they can be carried in a bag or wheeled. They also contain their own power supply. Most deliver oxygen in a pulsed dose, which means you receive oxygen when you breathe in, but not when you breathe out. This makes the machine lighter and also preserves battery life. Other machines can deliver the oxygen via continuous flow.
Portable concentrators are quite expensive and normally require you to fund them yourself. It may be possible to purchase one second hand.
2 Oxygen cylinders
Large freestanding or stationary cylinders
These are sometimes provided as a back-up for people prescribed long-term oxygen therapy, in case there is a problem with their concentrator or a lengthy power blackout.
Portable cylinders
These smaller cylinders can be used when leaving the home. They can be wheeled, attached to a wheeled walker or wheelchair, or may be carried in a bag or backpack. Once empty, these cylinders need to be refilled and are best used with oxygen conservers that make them last longer.
3 Nasal prongs
Oxygen is usually delivered to your lungs through soft nasal prongs (sometimes called cannulae) that are worn in the nostrils. The tubing normally stays in place by being placed over the ears and under the chin. These allow you to eat or drink while taking in the oxygen10. The tubing can sometimes cause discomfort due to the dying of the lining of the nose. This can be improved by applying a water-based lubricant to the nose several times a day. Alternatively, a mask can be used instead of the prongs.
Oxygen should be considered as a drug that is prescribed and administered for specific indications, with
a documented target oxygen saturation range, and with regular monitoring of the patient’s response.
2. Oxygen is prescribed for the relief of hypoxaemia, not breathlessness.
3. Hypoxaemia is both a marker of risk of a poor outcome due to the severity of the underlying disease(s) that has caused hypoxaemia, and an independent risk factor of poor outcome.
4. There are risks associated with both hypoxaemia and hyperoxaemia, which underlie the importance of prescribing oxygen, only if required, to within a target oxygen saturation range.
The use of supplemental oxygen is not free of risk. When administered in supraphysiological doses, oxygen therapy can lead to diminished ventilatory drive, increased ventilation/perfusion mismatch, and consequent hypercapnia. However, controlled oxygen therapy, targeting an oxygen saturation in the 90%–92% range, is not likely to result in clinically significant hypercapnia.109 Oxygen administration has been shown to generate oxidative stress and airway inflammation, which could theoretically contribute to further tissue damage and progression of disease.5
Finally, the drawbacks of LTOT use are not all medical. Quite apart from significant financial cost, and the perceived societal stigma of LTOT, the combination of cigarette smoking and oxygen use is a potentially lethal one. Although this is generally considered to be an absolute contraindication to the prescription of supplemental oxygen, reports suggest up to 20% of COPD patients receiving LTOT may be active smokers