The next two articles will deal with the subject of oxygen therapy, the need for it and how it should be used. When treating patients with lung disease I think that there is no more misunderstood therapy than oxygen therapy. More than one million people receive long-term oxygen therapy in the United States alone. The cost of this therapy represents the highest direct cost related to COPD after hospitalizations.
Many patients and even some doctors do not understand who should be receiving this therapy. Let me first say that studies have clearly shown that for the patients who meet the specific criteria for oxygen therapy it can prolong survival but who are these patients? I am often asked by patients or their family as to whether or not oxygen therapy would help. Patients often
think that a lowered oxygen level makes them short of breath especially with exertion. The ability of patients to measure their own oxygen saturation levels with a finger probe makes for understandable concern.
The patients that benefit from the use of oxygen therapy need to have a specifically low oxygen level, ideally, measured by a blood gas test. The level needed to qualify depends on whether the patient has evidence of right heart failure or an elevated hemoglobin level. These limits are not designed to deny patients the benefits of oxygen therapy but rather to be sure that this life prolonging and expensive treatment is given to the patients who will truly benefit.
