Oxygen therapy in COPD and interstitial lung disease: navigating the knowns and unknowns

Abstract

Domiciliary oxygen therapy is often prescribed for patients with hypoxaemia due to advanced lung disease, most commonly chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). Long-term oxygen therapy (LTOT) trials conducted in patients with COPD in the 1980s remain the basis for clinical decisions and guideline recommendations regarding LTOT for patients with non-COPD conditions as there is a lack of high-quality evidence concerning its use in the non-COPD population. There is also a lack of evidence for the use of ambulatory and nocturnal oxygen therapy in patients with isolated exertional and nocturnal hypoxaemia. These deficiencies pose significant challenges in patient care, with consequent discrepancies in guideline recommendations and clinical approaches. In recent years, new studies have been and are currently being conducted to fill the gaps in our understanding and use of domiciliary oxygen therapy for other indications, including ILD. This article provides a comparison of the epidemiology and significance of hypoxaemia in patients with COPD and ILD, with an up-to-date review of current evidence regarding the role of different types of domiciliary oxygen therapy in these conditions.

Respiratory Rehabilitation for Post-Covid-19 Patients

“…(7,4 -8,0 кПа) у пациентов с лёгочным сердцем, полицитемией, лёгочной гипертензией. У пациентов с физиологическим уровнем гемоглобина критерием ДОТ является уровень насыщения артериальной крови кислородом (SpO 2 ) меньше 88% [6,25]. Цель: ликвидация/минимизация дыхательной недостаточности (ДН), стимуляция мукоцилиарного клиренса.…”

Oxygen Therapy: Systems and Indications in the Pediatric and Adult Population

“…It further decreased when applying a continuous regimen of 17.7 hours/day. Based on these results, the criteria for the indication of continuous home oxygen therapy were defined; based on: PaO 2 < 55 mmHg, or between 55 and 60 mmHg with the presence of peripheral edema, cor pulmonale, hematocrit values above 55%, stocks of cardiac arrhythmias and mental or central nervous system disorders that could be attributed to hypoxemia [24]. In the presence of these results, the use of oxygen therapy has spread to other pathologies that present with chronic respiratory failure with a pattern similar to COPD.…”

Effects of Supplemental Oxygen on Cardiovascular and Respiratory Interactions by Extended Partial Directed Coherence in Idiopathic Pulmonary Fibrosis

“…Conversely, oxygen therapy in COPD patients is clinically well-accepted and it is recommended to enhance exercise capacity (Stoller et al, 2010). However, some trials have not found enough evidence to support that long-term oxygen therapy improves COPD patients' mortality rate (Khor et al, 2019). It is important to point out that few studies have addressed the efficiency of oxygen administration in COPD and Interstitial Lung Disease (ILD) patients (Khor et al, 2019) and that studies about the ANS regulation in COPD patients were based on classic heart rate variability (HRV) parameters (Mohammed et al, 2017).…”