Supplementary Oxygen in COPD

Chronic obstructive pulmonary disease (COPD) makes breathing a struggle, and when breathing is problematic your body struggles to reach the desired level of oxygen in the blood. Your body’s organs depend on that oxygen to provide energy without it, your body shuts down.

With the breathing difficulty that is a keystone to COPD, many patients experience symptoms that warrant their doctor prescribing COPD oxygen therapy. Oxygen therapy is the use of an oxygen tank to supplement the oxygen your lungs are able to use from the air. A higher concentration inhaled equals more oxygen available in your body.

Whether you’re a newly diagnosed COPD patient or a COPD veteran, chances are if you haven’t already, at some stage it’s likely you’ll need supplementary oxygen.

If you are worried you may run out of oxygen consider oxygen conserving devices (OCD). They are used with a tank or oxygen concentrator so oxygen is delivered only when you inhale, making the supply of oxygen last longer. Make sure you get the oxygen saturation tested (at rest and with activity) when you first get an OCD to make sure you are breathing enough oxygen and ensure you find the best portable oxygen concentrator for you.

Need of Supplementary Oxygen?

COPD is a chronic airway obstruction that is characterized by damage to your lungs or airways and sometimes both. The damage is non-reversible and progressive.

The damage to the air sacs (alveoli) in our lungs makes it difficult to transfer oxygen and carbon dioxide between our lungs and bloodstream. When this occurs the levels of oxygen in our bloodstream is reduced, often to dangerous levels below 90 percent.

Healthy lungs maintain an oxygen saturation level above 96 percent. When our oxygen levels drop below 90 percent you can start to experience an increased shortness of breath and hypoxia.

Hypoxia is when your organs and tissues are not receiving enough oxygen. Prolonged hypoxia can cause serious and permanent damage to your organs.

Hypoxia can sometimes only affect patients when they’re at altitude, such as when they’re traveling by air. An altitude test can determine whether you will need supplementary oxygen when flying.

COPD patients who have ongoing problems with hypoxia are often prescribed supplementary oxygen to keep their oxygen saturation in a safe zone — between 92 and 100 percent. Your doctor will determine the amount of oxygen you’re prescribed after conducting oximetry or an arterial blood gas study.

Some patients will require supplementary oxygen for normal day-to-day activities, while others may only require it when they’re at altitude. Exercise can also affect a patient’s oxygen levels. Fortunately, there are ways to deliver oxygen even when you are mobile.

How it will Work?

Supplementary oxygen is delivered to a patient via the use of different types of oxygen equipment. The two most common delivery systems used are oxygen concentrators and medical oxygen cylinders.

Oxygen concentrators deliver oxygen to the patients via an electrical medical device that extracts air from the room air and then delivers it to the patient. A tube with a nasal cannula delivers the oxygen from the concentrator to the patient.

Concentrators have flow controls that can be tailored to the patients need and range in size and capacity.

Medical oxygen cylinders are a popular option with high liter flow users. In this system, the oxygen is stored in liquid form in a home reservoir, which must be filled on a regular basis.

The advantage of this system is they don’t require electricity to operate, however, one downside is the difficulty of them with transportation. But, there are smaller cylinders available for mobility.

Many patients use concentrators as their main source of oxygen with a medical cylinder as a backup for power outages.

Options for supplementary oxygen varies between jurisdictions and your healthcare professional will be able to assist you in obtaining the correct equipment for your needs.

Is Too Much Supplementary Oxygen is  Harmful in COPD Exacerbations?

Commonly supplemental oxygen therapy for patients in COPD exacerbation. We give enough O2 to prevent hypoxemia, but not so much that it causes hypoventilation or dangerous hypercarbia. If you’re like me then you’ve probably heard a number of conflicting theories as to WHY overzealous supplemental oxygen leads to bad outcomes in these patients.

Oxygen-Induced Hypoventilation

There are two central drivers of respiratory drive, hypercarbia and hypoxemia. Because COPD patients spend their lives chronically hypercarbic they no longer respond to that stimulus, and their only trigger for the respiratory drive is the level of oxygen (or lack thereof) in their blood. Supplemental O2 removes a COPD patient’s hypoxic respiratory drive causing hypoventilation with resultant hypercarbia, apnea, and ultimately respiratory failure.

Side Effects of Oxygen Therapy

Even though it is considered safe, some patients may still experience some side effects of oxygen therapy. An experienced medical professional must always administer the treatment.

These are some of the side effects of oxygen therapy:

• Bloody nose or skin irritation where oxygen is administered
• Morning headaches
• Fatigue

Side effects of transtracheal oxygen therapy, including infection, tube slipping, injury to the windpipe and mucus balls blocking the tube.

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2nd World Congress on COPD, Asthma and Lung Health

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