ATS makes recommendations on home oxygen therapy for COPD

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Wednesday, November 18, 2020

NEW YORK – The American Thoracic Society has posted online its latest clinical practice guideline on home oxygen therapy, addressing long-term and ambulatory therapy for adults with COPD. 

The guideline makes the following recommendations: 

  • In adults with COPD who have severe chronic resting room air hypoxemia, we recommend prescribing long-term oxygen therapy at least 15 hours per day. 
  • In adults with COPD who have moderate chronic resting room air hypoxemia, we suggest not prescribing LTOT. 
  • In adults with COPD who have severe exertional room air hypoxemia we suggest prescribing ambulatory oxygen. 


“Oxygen is a common, yet burdensome, equipment-laden therapy, so if we are going to prescribe it, there should be enough evidence that we can tell our patients what they should expect in terms of improving their symptoms, and the quality and quantity of their lives,” said Susan Jacobs, MS, RN, co-chair of the guideline committee and a research nurse manager in pulmonary, allergy and critical care medicine at Stanford University. 

The guideline, also published in the Nov. 15 issue of the American Journal of Respiratory and Critical Care Medicine, was borne out of an ATS workshop in 2017 on Optimizing Home Oxygen Therapy data, which “identified the lack of evidence-based clinical practice guidelines for appropriate use of home oxygen as a critical gap,” wrote the committee. 

The guideline also includes recommendations for liquid oxygen. In patients with chronic lung disease who are mobile outside of the home and require continuous oxygen flow rates of less than 3L/minute during exertion, the ATS suggests prescribing portable liquid oxygen. 

Additionally, the guideline makes recommendations for adults with interstitial lung disease.