Long-term Oxygen Therapy

The data demonstrating the valuable impact of oxygen administration on patient survival were published in the early 1980s. Despite that history and more recent evidence suggesting the benefit of long-term oxygen therapy (LTOT) in the management of lung diseases, almost 30 years later, many deficits remain in the knowledge of clinicians regarding indications for prescription.

Moreover, rapidly changing technology and the availability of many types of oxygen delivery equipment make it difficult for the practicing pulmonologist to keep up with available devices. Physicians generally prescribe oxygen as a number of liters per minute but may not properly prescribe therapy that takes into account a patient’s increased oxygen demands during exercise and, perhaps, during sleep.

For example, patients generally prefer portable oxygen devices, and these devices may perform well when the patient is at rest. However, upon exertion, as both the minute ventilation and respiratory rate increase, many devices will not be adequate.

The Airways Disorders, Allied Health, and Respiratory Care NetWorks assembled a task force to review LTOT. The task force’s purpose was to evaluate the indications, prescribing requirements, and available devices for providing LTOT. Their report endeavors to clarify all that the clinician should take into account when prescribing LTOT. The task force hopes to publish the full document on the ACCP Web site for easy accessibility and to also make a summary recommendation on LTOT available in an easy-to-carry format.

Dr. Rubin Cohen, FCCP
Vice-Chair, Airways Disorders