Copd: Long-Term Oxygen Therapy

Key points

• Assess for long-term oxygen therapy (LTOT) in COPD with very severe airflow obstruction (FEV1 under 30% predicted); consider assessment if severe (FEV1 30-49%).
• Also assess if there is cyanosis, polycythaemia, peripheral oedema, a raised JVP, or oxygen saturations 92% or less on air.
• Confirm with two arterial blood gases at least 3 weeks apart when clinically stable.
• Offer LTOT if PaO2 is under 7.3 kPa, OR 7.3-8.0 kPa with secondary polycythaemia, peripheral oedema or pulmonary hypertension.
• Use for at least 15 hours a day. Do NOT offer LTOT to people who continue to smoke (fire risk and limited benefit).