Jón Steinar Jónsson gp 09

Oxygen therapy in copdNordic congress in general practice 2009

Jón Steinar Jónsson gp 09

O2 therapy in copd

• Increase life expectancy in copd patients with chronic hypoxemi (PaO2<7,4 kPa)

• Decrease symtoms of hypoxemi such as edema but has little effect on dyspne

• In moderate hypoxemi (PaO2 7,4-8 kPa), same effect on symptoms

•

Jón Steinar Jónsson gp 09

NICENational institute for Health and Clinical

excellence:• 1.2.7.2 LTOT is indicated in patients with

COPD who have a PaO2 less than 7.3 kPa when stable or a PaO2greater than 7.3 and less than 8 kPa when stable and one of: secondary polycythaemia, nocturnal hypoxaemia (oxygen saturation of arterial blood [SaO2] less than 90% for more than 30% of time), peripheral oedema or pulmonary hypertension.

• A

Jón Steinar Jónsson gp 09

NICE

• 1.2.7.3 To get the benefits of LTOT patients should breathe supplemental oxygen for at least 15 hours per day. Greater benefits are seen in patients receiving oxygen for 20 hours per day. A

Jón Steinar Jónsson gp 09

Oxygen therapy in copd

• 1.2.7.4 The need for oxygen therapy should be assessed in: ･• all patients with severe airflow obstruction (FEV1less than

30% predicted) • ･ patients with cyanosis ･• patients with polycythaemia ･• patients with peripheral oedema ･• patients with a raised jugular venous pressure • patients with oxygen saturations less than or equal to 92%

breathing air. • Assessment should also be considered in patients with

moderate airflow obstruction (FEV130-49% predicted). • D

Jón Steinar Jónsson gp 09

Oxygen therapy in copd

• 1.2.7.5 To ensure all patients eligible for long-term oxygen therapy (LTOT) are identified, pulse oximetry should be available in all healthcare settings.

• D

Jón Steinar Jónsson gp 09

Jón Steinar Jónsson gp 09

Grading scheme

• A - systematic reviews or metaanalysis

• B - controlled trials

• D - expert committee report