Abstract
The beneficial effects of ambulatory home oxygen have been demonstrated since the 1950s, when Cotes and Gibson gave oxygen to ambulatory COPD patients from small portable high pressures cylinders in the United Kingdom. Over the ensuing 7 decades, oxygen has been prescribed to millions of COPD patients in the home setting. Additionally, it is common clinical practice to prescribe supplemental oxygen when chronic hypoxemic respiratory failure not due to COPD (eg, interstitial lung disease, pulmonary hypertension, kyphoscoliosis, and cystic fibrosis) is present or in patients with hypoxemia at hospital discharge following flares of their underlying chronic respiratory disorder, without any substantial evidence. Despite the importance of long-term oxygen therapy in clinical home management, there are many gaps in our current knowledge regarding its mechanisms of action, indications for prescription, and its effects on important patient outcomes. Research conducted in the 1970s and 1980s still provides the basis for clinical decision making and insurance coverage policies regarding long-term oxygen administration. Remarkably, little current research is being conducted to extend our knowledge regarding the indications, mechanisms, and benefits of long-term oxygen therapy. This review will focus on our current knowledge of the end points for supplemental oxygen at home, such as mortality, effects on functional performance, sensation of dyspnea, cognitive function, and quality of life, and highlight areas where future research is needed.
Footnotes
- Correspondence: Gerard J Criner MD, Division of Pulmonary and Critical Care Medicine, 845 Parkinson Pavilion, Temple University Hospital, 3401 N Broad Street, Philadelphia PA 19140. E-mail: Gerard.Criner{at}tuhs.temple.edu.
Dr Criner presented a version of this paper at the 50th Respiratory Care Journal Conference, “Oxygen,” held April 13–14, 2012, in San Francisco, California.
The author has disclosed no conflicts of interest.
↵* Joseph S Lewarski RRT FAARC, Invacare, Elyria, Ohio.
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