Key Points
➤ Worldwide, millions are prescribed Long-Term Oxygen Therapy (LTOT),
defined as oxygen prescribed for at least 15 h/d.
➤ This clinical guideline incorporates recent evidence and integrates
differences in home oxygen needs and experiences across patients with
different lung diseases, lifestyles, and oxygen supply requirements.
Treatment
Chronic Obstructive Pulmonary Disease
➤ In adults with chronic obstructive pulmonary disease (COPD) who have
severe chronic resting room air hypoxemia,
a
the ATS recommends
prescribing long-term oxygen therapy (LTOT) for at least 15 h/d (S-M).
a
Severe hypoxemia is defined as meeting either of the following criteria:
1. Pa
O2
≤55 mm Hg (7.3 kPa) or oxygen saturation as measured by pulse oximetry (Sp
O2
) ≤88%
2. Pa
O2
= 56–59 mm Hg (7.5–7.9 kPa) or Sp
O2
= 89% plus one of the following : edema, hematocrit ≥55%,
or P pulmonale on an ECG.
➤ In adults with COPD who have moderate chronic resting room air
hypoxemia,
a
the ATS suggests not prescribing LTOT (C-L).
a
Moderate hypoxemia is defined as an Sp
O2
of 89–93%.
➤ In adults with COPD who have severe exertional room air hypoxemia, the
ATS suggests prescribing ambulatory oxygen (C-L).
Interstitial Lung Disease
➤ For adults with interstitial lung disease (ILD) who have severe chronic
resting room air hypoxemia, the ATS recommends prescribing LTOT for at
least 15 h/d (S-VL).
➤ For adults with ILD who have severe exertional room air hypoxemia, the
ATS suggests prescribing ambulatory oxygen (C-L).
Liquid Oxygen
➤ In patients with chronic lung disease who are mobile outside of the home
and require continuous oxygen flow rates of >3 L/min during exertion, the
ATS suggests prescribing portable liquid oxygen (LOX) (C-VL).
