Oxygen therapy for chronic breathlessness in palliative care

Long-term oxygen therapy for hypoxic respiratory failure reduces mortality in patients with hypoxaemic chronic obstructive pulmonary disease (COPD); however, the effect on quality of life is less certainMcDonald, 2016. Healthcare professionals and patients should balance the benefits of oxygen (ie potential symptom relief) against the burdens of restricted movement, social isolation, pressure areas from oxygen tubing, and nasal irritation and bleeding associated with the use of oxygen for more than 18 hours a day (the suggested duration).

Ambulatory oxygen can be considered for patients who only become hypoxic on walking, to allow better participation in walking and exercise. However, evidence for the use of oxygen for exertional hypoxia alone is not strong, and oxygen use for these patients is not considered essentialAmeer, 2014.

For general information on long-term oxygen therapy and ambulatory oxygen, see Domiciliary oxygen therapy in the Respiratory guidelines.