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Which patients with moderate hypoxemia benefit from long-term oxygen therapy? Ways forward

Authors Ekström M, Ringbaek T

Received 9 August 2017

Accepted for publication 11 December 2017

Published 9 January 2018 Volume 2018:13 Pages 231—235


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 4

Editor who approved publication: Dr Richard Russell

Magnus Ekström,1 Thomas Ringbaek2

1Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden; 2Respiratory Department, Hvidovre Hospital, Copenhagen, Denmark

Abstract: Long-term oxygen therapy (LTOT) improves prognosis in patients with COPD and chronic severe hypoxemia. The efficacy in moderate hypoxemia (tension of arterial oxygen; on air, 7.4−8.0 kPa) was questioned by a recent large trial. We reviewed the evidence to date (five randomized trials; 1,191 participants, all with COPD). Based on the current evidence, the survival time may be improved in patients with moderate hypoxemia with secondary polycythemia or right-sided heart failure, but not in the absence of these signs. Clinically, LTOT is not indicated in moderate hypoxemia except in the few patients with polycythemia or signs of right-sided heart failure, which may reflect more chronic and severe hypoxemia.

Keywords: survival, oxygen therapy, hypoxemia, COPD

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