![]() A meta-analysis by Ekström et al 12 aimed to assess how the use of LTOT affects breathlessness and health-related quality of life in patients with COPD and mild to moderate hypoxemia. 10, 11 An end point that may explain the widespread use of LTOT to prevent adverse events is the potential symptomatic benefit of supplemental oxygen in patients with dyspnea. Supplemental LTOT became the standard of care for patients with COPD with severe hypoxemia, but its utility in the context of mild to moderate hypoxemia is unclear. 6 However, the decrease in mortality rates of patients with mild or moderate hypoxemia who received LTOT has not been routinely demonstrated in subsequent studies. ![]() 9 This study was followed by the British Medical Research Council Hypoxemia Trial, 6 which further demonstrated a reduction in mortality in patients with COPD who received LTOT for more than 15 hours per day compared with no oxygen therapy (room air). 9 This study demonstrated that in patients with COPD and chronic, severe hypoxemia, continuous LTOT significantly reduced mortality and improved hematocrit levels and pulmonary vascular resistance when compared with nocturnal oxygen therapy alone. The notion that LTOT improves the mortality rate in patients with COPD is derived from studies published in the 1980s, such as the Nocturnal Oxygen Therapy Trial. Recommendation: Physicians should prescribe LTOT on an individual basis in accordance with patients’ symptoms. 9Ĭlinical Question: Should long-term oxygen therapy (LTOT) be provided to patients with stable chronic obstructive pulmonary disease (COPD) who have moderate hypoxemia?Įvidence: Despite existing guidelines recommending LTOT for all patients with COPD and hypoxemia, a decreased mortality rate in patients with COPD and mild or moderate hypoxemia who receive LTOT has not been routinely demonstrated. For the purposes of this review, moderate hypoxemia is defined as a Po 2 value of 56 to 59 mm Hg or oxygen saturation as measured by pulse oximetry (Spo 2) of 88% to 90%, with the ability to concurrently maintain oxygen saturations greater than 80% on a 6-minute walk test and 88% at rest. In this review, we analyzed the available data and addressed the clinical question of whether LTOT increases the survival rate of patients with stable COPD and moderate hypoxemia. 6 However, the mortality benefit of this therapy in patients with COPD with mild to moderate hypoxemia is unclear, with limited evidence for its use in the literature. ![]() 5 Long-term oxygen therapy has been widely accepted as a means to lower the mortality rate in patients with COPD, particularly in patients with severe hypoxemia. 4 Among patients with COPD in the United States, approximately 800,000 receive long-term oxygen therapy (LTOT). 3 The cost of COPD in the United States was projected to be $50 billion in 2010. 1 It affects roughly 14% of the male and 7% of the female population globally, 2 and it is the third-leading cause of death in the United States. ![]() Chronic obstructive pulmonary disease (COPD) is an irreversible lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |