Clinical controversies addressed in oxygen guidelines

Tuesday, 28 Apr 2015

Updated guidelines on the use of oxygen in the home address clinical controversies such as oxygen prescription to smokers, provision of oxygen on discharge from hospital, and the use of palliative oxygen.

Published in Thorax this week the guidelines from the British Thoracic Society also explore the evidence base for use of different modalities of oxygen and patient related outcomes such as effects on mortality, symptoms and quality of life.

Key recommendations:

  1. Long-term oxygen therapy (LTOT) remains the most evidence-based form of home oxygen therapy, with no change to current indications and thresholds.
  2. Ambulatory oxygen therapy assessment should only be offered to patients already on LTOT if they are mobile outdoors.
  3. Treatment with palliative oxygen therapy does not have a role in patients with cancer or end-stage cardio-respiratory disease with intractable breathlessness if their resting oxygen levels are normal or only mildly hypoxaemic but above current LTOT thresholds.
  4. Short burst oxygen therapy should not be ordered for use prior to or following exercise in chronic obstructive pulmonary disease patients whether or not they have resting hypoxaemia.
  5. A risk assessment approach should be adopted for assessing safety of all forms of home oxygen especially in smokers.

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