Delivery of oxygen via nasal cannula, mask, or concentrator to patients with low blood oxygen levels. It can prolong survival in COPD and other chronic lung diseases.
Indication
- Chronic hypoxemic respiratory failure on the basis of chronic obstructive pulmonary disease (COPD) — at rest, PaO2 <55 mmHg or SaO2 <88
- Use at PaO2 56-59 mmHg / SaO2 89 in patients with pulmonary hypertension, right heart failure, or hematocrit >55%
- Idiopathic pulmonary fibrosis and other interstitial lung diseases
- Chronic hypoxemia due to cystic fibrosis and bronchiectasis
- Palliative use in lung cancer or advanced respiratory diseases
- Temporary oxygen need during acute exacerbations, pneumonia, and heart failure
- Desaturation during exercise or sleep (exercise-induced/nocturnal hypoxemia)
Preparation
- Arterial blood gas (ABG) analysis and resting fingertip oxygen saturation (SpO2) measurement
- Decision based on two separate ABG measurements during a stable period, with no exacerbations in the last 30 days
- Pulmonary function test (spirometry), chest X-ray, and sleep study (polysomnography) when needed
- Evaluation of smoking — smoking cessation is required due to the fire risk associated with oxygen
- Information on electrical infrastructure and device maintenance for home use
How it's performed
- Once the indication is confirmed, the physician sets the appropriate flow rate (usually 1-3 L/min) and daily duration (at least 15 hours/day)
- Selection of an oxygen source: oxygen concentrator (most common), pressurized cylinder, or portable oxygen device
- A nasal cannula or face mask is fitted; protection of skin contact points is recommended
- Target saturation is generally titrated to SpO2 88-92% in COPD and 94-98% in other patients
- The patient is instructed on device use, cleaning, alarm management, and travel with oxygen
- Safety information is provided emphasizing that smoking, open flames, and oily creams pose a fire risk
Post-procedure
- Follow-up within the first 1-3 months to evaluate treatment response and adherence
- ABG and SpO2 with reassessment of the flow rate at least 1-2 times per year
- Regular monitoring of pulmonary function tests and clinical condition
- Vaccination (influenza, pneumococcal, COVID-19) and pulmonary rehabilitation referral
- Device calibration, filter/humidifier replacement, and technical service follow-up
Risks
- CO2 retention at high flow rates (especially in COPD patients, accumulation of carbon dioxide)
- Nasal mucosal dryness, bleeding, and skin irritation from cannula friction
- Fire and burn risk (oxygen accelerates combustion; smoking and flames are strictly prohibited)
- Failure to reach target saturation due to insufficient flow or poor adherence
- Pulmonary toxicity with prolonged use of high oxygen concentrations (rare)
FAQ
Will oxygen therapy make my lungs 'lazy'?
Oxygen used at the flow rate set by the physician does not make the lungs lazy. On the contrary, in patients with proper indications, it prolongs survival and improves quality of life.
How many hours per day should I use it?
In long-term oxygen therapy, benefit is achieved with at least 15 hours per day, and ideally 24 hours. The duration must be set according to your physician's recommendation.
Is there a difference between an oxygen concentrator and a cylinder?
A concentrator extracts oxygen from the air using electricity and is practical for home use. Cylinders are portable but provide a limited duration. The choice is made together with your physician based on your needs and mobility.
Can I continue smoking?
No. Smoking both worsens the underlying disease and creates serious fire and burn risks during oxygen use. It is recommended that you receive smoking cessation support.
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