COPD: Long Term Oxygen Therapy
#NEETPG #FMGE #INICET #COPD
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Long term oxygen therapy is the only pharmacological intervention that is demonstrated to reduce mortality in patients of Chronic obstructive lung disease. So here is a quick look at indications for LTOT @1L/min for 15 hours per day.
- Resting sp02 of less than 88% or p02< 55 mm Hg
- sp02 < 89% (p02 56-59 mm Hg) with Pulmonary artery hypertension
- sp02 < 89% (p02 56-59 mm Hg) with right sided congestive heart failure
- sp02 < 89% (p02 56-59 mm Hg) with Erythrocytosis
The benefit of mortality reduction is directly proportional to number of hours oxygen is used. Mostly oxygen concentrator is used to ensure good quality of life. Next step for a would be to develop inhouse portable systems in India that allow mobility outside the home.
The long-term hypoxia caused pulmonary vasoconstriction that leads to pulmonary artery hypertension. Loud P2, Narrow split S2 are auscultatory findings to be looked out for. Mean pressure >20 mmHg is threshold for diagnosis of PAH. Hypoxia leads to increased RBC count and secondary polycythemia.
