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A Review of Long-term Oxygen Therapy in Chronic Obstructive Pulmonary Disease

Alshabani, Khaled, MD*; Stoller, James, K., MD, MS

doi: 10.1097/CPM.0000000000000235
Obstructive Airways Disease

Supplemental oxygen is a time-honored therapy for patients with chronic obstructive pulmonary disease (COPD), with varying indications. Classic studies demonstrate the benefit of supplemental oxygen in COPD patients with resting hypoxemia used as close to 24 hours daily as possible. Yet, the role of supplemental oxygen in other clinical contexts for these patients (eg, mild resting hypoxemia, desaturation with activity only, or nocturnal desaturation) is less clear. The current paper reviews the evidence with regard to the use of supplemental oxygen for patients with COPD in these various settings. Recently, the Long-term Oxygen Treatment Trial, a randomized controlled trial that addressed the role of supplemental oxygen in patients with mild resting hypoxemia and/or exertional desaturation, showed no benefit in this setting on the basis of a composite outcome of all-cause hospitalization and mortality. Yet, some advocate individual trials of supplemental oxygen in such patients and basing treatment decisions on subjective benefit. Data with regard to the use of supplemental oxygen for such patients in other contexts are more sparse, and further study is clearly warranted for this commonly encountered clinical issue.

*The Respiratory Institute

Education Institute, Cleveland Clinic Foundation, Cleveland, OH

Disclosure: J.K.S. has served as a consultant to Grifols, Shire, Respironics, and CSL-Behring, and has research funding from the NHLBI, Alpha-1 Foundation, and CSL-Behring. The remaining author declares that there is no conflicts of interest.

Address correspondence to: Khaled Alshabani, MD, Cleveland Clinic Foundation, Crile Building, 9500 Euclid Avenue, A90, Cleveland, OH 44195. E-mail:

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