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Chapter-06 Chronic Obstructive Pulmonary Disease

BOOK TITLE: Manual of Respiratory Medicine

Author
1. Hira Harmanjit Singh
ISBN
9788184484366
DOI
10.5005/jp/books/10485_6
Edition
1/e
Publishing Year
2008
Pages
10
Author Affiliations
1. Maulana Azad Medical College, Lok Nayak and GB Pant Hospitals, New Delhi, India, Respiratory ICU and Sleep Centre, Maulana Azad Medical College and Associated LN and GB Pant Hospitals, New Delhi, Maulana Azad Medical College and Associated Hospitals, New Delhi, India, Maulana Azad Medical College and Associated Hospitals New Delhi, India
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Abstract

Oxygen therapy is useful in the treatment of COPD since the 1970s because of the positive impact on mortality and morbidity of home use of oxygen. Long-term oxygen therapy (LTOT) has become widely accepted in the last 30 years in selected, continuously hypoxemic patients based on two milestone studies. On the other hand, when hypoxemia is intermittent (i.e., associated with exercise, sleep, or eating), the use of oxygen remains an area of debate for physicians. Despite extensive work by many investigators that has helped our understanding of the mechanisms believed to be responsible for intermittent hypoxemia, the therapeutic benefits of supplemental oxygen in this setting remain needs trials. LTOT is essential for patients with a PaO2 of less than 55 mm Hg, PaO2 < 59 mm Hg with evidence of polycythemia, or cor pulmonale. Many patients with COPD who are not hypoxemic at rest worsen during exertion. Dose of oxygen is 1-2 L per minute. During exercise or sleep, increase oxygen 0.5 L per minute. Primary goal is to increase the baseline PaO2 to at least 60 mmHg (90% SaO2). Reevaluate these patients 1-3 months after initiating therapy because some patients may not require long-term oxygen.

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