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Myths and facts around the use of
long-term oxygen therapy
12
RESPIRATORY CARE TODAY
2015,Vol 1, No 1
Myth
‘OXYGEN CONCENTRATORS
REMOVE OXYGEN FROM
THE ROOM’
Fact
Long-term oxygen therapy (LTOT) is
delivered via an oxygen concentrator
— a motor driven machine that
plugs into an electrical supply and
filters the air in a room through a
series of internal chemical filters,
venting nitrogen as a‘waste’gas. The
concentrated oxygen is stored in a
small reservoir and delivered to the
patient via standard oxygen delivery
devices, usually nasal cannulae.
Oxygen in the surrounding room air
(21% at sea level) is not depleted, as
only a small amount of room air is
filtered and the concentrated oxygen
is delivered continuously, with a
proportion of the concentrated supply
being released into the atmosphere.
Myth
‘ALL PATIENTS WHO ARE BREATH-
LESS NEED HOME OXYGEN’
Fact
Oxygen therapy treats hypoxaemia,
specifically. In the absence of low
oxygen levels, breathlessness is not
relieved by oxygen therapy. In a
randomised controlled trial (RCT) of
patients with COPD and moderate
hypoxaemia (7.4–8.7kPa), Gorecka et
MYTHS AND FACTS: LONG-TERM OXYGEN THERAPY
i
Sandra Olive, respiratory nurse specialist,
Norfolk and Norwich University Hospital
al (1997) found no survival benefit in
those receiving LTOT for at least
15 hours per day compared to controls.
Breathlessness in chronic
respiratory disease is often exacerbated
by progressive inactivity and
muscle deconditioning. Pulmonary
rehabilitation comprises patient
education and targeted exercise to
retrain skeletal muscles and, in COPD,
has been shown to significantly
improve functional capacity and
perception of breathlessness
(McCarthy et al, 2015).
^^
Severe resting hypoxaemia...
... is defined in the MRC and NOTT trials as arterial oxygen (PaO
2
) less
than or equal to 7.3kPa or 2.4–7.8kPa, in the presence of signs of
cor pulmonale
(abnormal enlargement of the right side of the heart) or polycythaemia (a rare
condition that results in the bone marrow producing too many red blood cells).
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