Long-term Oxygen Treatment in Chronic Obstructive Pulmonary Disease: Recommendations for Future Research: An NHLBI Workshop Report

• Published in: American journal of respiratory and critical care medicine Vol. 174; no. 4; pp. 373 - 378
• Main Authors: Croxton, Thomas L, Bailey, William C, NHLBI Working Group on Long-term Oxygen Treatment in COPD
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 15.08.2006; American Lung Association; American Thoracic Society
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease, asthma; Clinical decision making; Clinical trials; Clinical Trials as Topic; Diseases of the respiratory system; Exercise; Humans; Hypoxia - therapy; Immunization; Intensive care medicine; Lungs; Medicaid; Medical sciences; Medicare; Mortality; Nhlbi Workshop; Oxygen Inhalation Therapy - adverse effects; Oxygen Inhalation Therapy - economics; Patient Selection; Physical fitness; Pneumology; Pulmonary arteries; Pulmonary Disease, Chronic Obstructive - economics; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); United States; Ventilators; Working groups; Lung disease; Oxygen; Intensive care; Respiratory disease; Chronic disease; Recommendation; Inhalation; Chronic; chronic bronchitis; hypoxia; Treatment; Bronchus disease; Hypoxia; therapy; lung diseases; Bronchitis; Obstructive pulmonary disease; Emphysema; obstructive; oxygen inhalation therapy; pulmonary emphysema; Resuscitation
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.200507-1161WS

Long-term oxygen treatment (LTOT) prolongs life in patients with chronic obstructive pulmonary disease (COPD) and severe resting hypoxemia. Although this benefit is proven by clinical trials, scientific research has not provided definitive guidance regarding who should receive LTOT and how it should be delivered. Deficiencies in knowledge and in current research activity related to LTOT are especially striking in comparison to the importance of LTOT in the management of COPD and the associated costs. The National Heart, Lung, and Blood Institute, in collaboration with the Centers for Medicare and Medicaid Services, convened a working group to discuss research on LTOT. Participants in this meeting identified specific areas in which further investigation would likely lead to improvements in the care of patients with COPD or reductions in the cost of their care. The group recommended four clinical trials in subjects with COPD: (1) efficacy of ambulatory O(2) supplementation in subjects who experience oxyhemoglobin desaturation during physical activity but are not severely hypoxemic at rest; (2) efficacy of LTOT in subjects with severe COPD and only moderate hypoxemia; (3) efficacy of nocturnal O(2) supplementation in subjects who show episodic desaturation during sleep that is not attributable to obstructive sleep apnea; and (4) effectiveness of an activity-dependent prescription for O(2) flow rate that is based on clinical tests performed at rest, during exercise, and during sleep.