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#LTOT_in_COPD

#long_term_oxygen_therapy
✍Patients who receive LTOT should breathe supplementary oxygen for at least 15 hours
a day as this reduce mortality.
Oxygen concentrators are used to provide a fixed supply for LTOT.

#Assess patients if any of the following:
🔸 very severe airflow obstruction (FEV1 < 30% predicted).
🔸 Assessment should be 'considered' for patients with severe airflow obstruction (FEV1 30-49% predicted)
🔸 cyanosis
🔸 polycythaemia
🔸 peripheral oedema
🔸 raised jugular venous pressure
🔸 oxygen saturations less than or equal to 92% on room air

#Assessment is done by measuring arterial blood gases on 2 occasions at least 3 weeks apart in patients with stable COPD on optimal management.

#Offer_LTOT_to :
✍patients with a pO2 of < 55 mm Hg (7.3kpa) or SaO2 less than 88% with or without hypercapnia
or
✍to those with a pO2 of 55 - 60 mm Hg (7.3-8kpa) or SaO2 less than 88% with one of the following:
✔secondary polycythaemia
✔nocturnal hypoxaemia
✔peripheral oedema
✔pulmonary hypertension 

#Goals
Oxygen should be administered by nasal cannula or face mask, at 1 to 2 L/min, which provides 24% to 28% oxygen to #Improve PaO2 >60 mm Hg or SaO2 to 88% to 92%.
#N.B :
✍Improving oxygenation above 92% is not helpful and in patients with chronic hypercarbic respiratory failure hypoxemia can worsen V/Q matching and precipitate worsening hypercarbia.

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