ABC of oxygen: Provision of oxygen at home
1998; BMJ; Volume: 317; Issue: 7163 Linguagem: Inglês
10.1136/bmj.317.7163.935
ISSN0959-8138
Autores Tópico(s)Delphi Technique in Research
ResumoBefore patients in the United Kingdom are given long term oxygen therapy at home they must have arterial blood gas analysis, which is done at a hospital laboratory. The assessment should be supervised by a respiratory physician. In England and Wales this conflicts with the need for home oxygen to be prescribed by the patient's general practitioner. In Scotland arrangements are made by the respiratory specialist. Close liaison between general practice and hospital is necessary to ensure appropriate care for the patient. Often this is best organised by respiratory specialist nurses and practice nurses. Patient using oxygen at home The assessments should be made with the patient in a stable state on optimal treatment and must be confirmed by a second assessment at least three weeks later. Several studies show that results from a single estimation are not always confirmed by a repeat analysis 4-12 weeks later. Although the UK criteria specify an arterial carbon dioxide pressure (PaCO2) >6 kPa for treatment, it is accepted that patients with a lower PaCO2 should have the same treatment. Criteria in other countries differ slightly. View this table: Criteria for long term oxygen in different countries The aim of long term oxygen therapy is to maintain arterial oxygen pressure (PaO2) at 9.3-12 kPa. This is usually achieved by a flow rate of 1-3 l/min. Ideally the PaO2 should be over 10.7 kPa to allow for falls during exercise, eating, sleeping, etc. #### Prescription of long term oxygen in chronic obstructive pulmonary disease Most doctors would not prescribe home oxygen for people who continue to smoke. The evidence of …
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