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Home oxygen

Key sources
The following summarized guidelines for the evaluation and management of home oxygen are prepared by our editorial team based on guidelines from the British Thoracic Society (BTS 2015).
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Guidelines

1.Screening and diagnosis

Indications for assessment: refer patients with a resting oxygen saturation of ≤ 92% for a blood gas assessment in order to assess eligibility for long-term oxygen therapy.
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2.Diagnostic investigations

Blood gas analysis: obtain an arterial blood gas in patients being assessed for long-term oxygen therapy.
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  • Pulse oximetry

3.Medical management

General principles: order long-term oxygen therapy for a minimum of 15 hours per day; up to 24 hours per day may be of additional benefit.
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  • Assessment of stability

  • Smoking cessation

  • Oxygen delivery device

  • Oxygen humidification

  • Oxygen carrying equipment

  • Nocturnal oxygen therapy

  • Ambulatory oxygen therapy

  • Palliative oxygen therapy

  • Short-burst oxygen therapy

4.Specific circumstances

Patients with chronic obstructive pulmonary disease: offer long-term oxygen therapy to patients with stable COPD and a resting PaO2 ≤ 55 mmHg (7.3 kPa).
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  • Patients with ILD

  • Patients with cystic fibrosis

  • Patients with pulmonary hypertension

  • Patients with neuromuscular or chest wall disorders

  • Patients with HF (long-term oxygen therapy)

  • Patients with HF (nocturnal oxygen therapy)

  • Patients with obstructive sleep apnea

  • Patients who smoke

5.Patient education

General counseling: arrange for the patient to receive formal education on long-term oxygen therapy by a specialist home oxygen assessment team, in order to ensure compliance with therapy.
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  • Oxygen transport

  • Safe oxygen use

6.Follow-up and surveillance

Assessment of treatment response: obtain an arterial blood gas after oxygen titration is complete in patients under long-term oxygen therapy, in order to determine whether adequate oxygenation has been achieved without precipitating respiratory acidosis and/or worsening hypercapnia.
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  • Follow-up clinical assessment

  • Follow-up home visits