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Oxygen therapy in copd Nordic congress in general practice 2009. 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
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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
Grading scheme • A - systematic reviews or metaanalysis • B - controlled trials • D - expert committee report Jón Steinar Jónsson gp 09