Oxygen Attack

Patients with severe COPD and other lung diseases, such as interstitial fibrosis, demonstrate a significant reduction in their oxygen levels during the day.  The need for oxygen therapy is defined by one of two measurements: pulse oximetry (the device put on your finger) value of 88% or less at rest, or direct measurement of your oxygen level by taking a sample from an artery, which demonstrates an oxygen level of 55mmHg or less at rest.  Patients who meet these criteria and get and use their oxygen have an improved level and length of survival.

            Next to hospitalization, the use of oxygen therapy by patients with chronic lung disease is the next most expensive line item.  It comes as no surprise to me that the government and the medical insurance industry are taking a careful look at the need for oxygen therapy.  One area of concern is patients using oxygen at night for demonstrated periods of lowered oxygen levels while sleeping.  The question being asked is whether or not oxygen at night, when none is required during the day, has any benefit. The benefit, as I have indicated, is a longer life.  Several studies have tried to answer this question.  The current impression I get is that the use of oxygen at night, when not required during the day (by the criteria mentioned above), does not appear to have benefit.

            A recent VA directive further says that oxygen desaturation (reduced oxygen level) with activity is no longer a routine indication for oxygen.