Jón Steinar Jónsson gp 09 Oxygen therapy in copd Nordic 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 NICE National institute for Health and Clinical excellence: 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 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 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 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