Home Oxygen Therapy for Adults with Chronic Lung Disease. An Official American Thoracic Society Clinical Practice Guideline

• Published in: American journal of respiratory and critical care medicine Vol. 202; no. 10; pp. e121 - e141
• Main Authors: Jacobs, Susan S, Krishnan, Jerry A, Lederer, David J, Ghazipura, Marya, Hossain, Tanzib, Tan, Ai-Yui M, Carlin, Brian, Drummond, M Bradley, Ekström, Magnus, Garvey, Chris, Graney, Bridget A, Jackson, Beverly, Kallstrom, Thomas, Knight, Shandra L, Lindell, Kathleen, Prieto-Centurion, Valentin, Renzoni, Elisabetta A, Ryerson, Christopher J, Schneidman, Ann, Swigris, Jeffrey, Upson, Dona, Holland, Anne E
• Format: Journal Article
• Language: English
• Published: United States American Thoracic Society 15.11.2020
• Subjects: Adult; Aged; Aged, 80 and over; American Thoracic Society Documents; Best practice; Chronic obstructive pulmonary disease; Clinical Medicine; Clinical practice guidelines; Evidence-Based Medicine - standards; Female; Home Care Services - standards; Home health care; Humans; Hypoxemia; Interstitial lung disease; Klinisk medicin; Lung Diseases, Interstitial - therapy; Lungmedicin och allergi; Male; Medical and Health Sciences; Medical procedures; Medicin och hälsovetenskap; Middle Aged; Mobility; Oxygen Inhalation Therapy - methods; Oxygen Inhalation Therapy - standards; Oxygen therapy; Practice Guidelines as Topic; Pulmonary Disease, Chronic Obstructive - therapy; Quality of life; Respiratory Medicine and Allergy; Societies, Medical; United States; United States; hypoxemia; mobility; quality of life; interstitial lung disease; chronic obstructive pulmonary disease
• ISSN: 1073-449X; 1535-4970; 1535-4970
• DOI: 10.1164/rccm.202009-3608ST

Evidence-based guidelines are needed for effective delivery of home oxygen therapy to appropriate patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). The multidisciplinary panel created six research questions using a modified Delphi approach. A systematic review of the literature was completed, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to formulate clinical recommendations. The panel found varying quality and availability of evidence and made the following judgments: ) strong recommendations for long-term oxygen use in patients with COPD (moderate-quality evidence) or ILD (low-quality evidence) with severe chronic resting hypoxemia, ) a conditional recommendation against long-term oxygen use in patients with COPD with moderate chronic resting hypoxemia, ) conditional recommendations for ambulatory oxygen use in patients with COPD (moderate-quality evidence) or ILD (low-quality evidence) with severe exertional hypoxemia, ) a conditional recommendation for ambulatory liquid-oxygen use in patients who are mobile outside the home and require >3 L/min of continuous-flow oxygen during exertion (very-low-quality evidence), and ) a recommendation that patients and their caregivers receive education on oxygen equipment and safety (best-practice statement). These guidelines provide the basis for evidence-based use of home oxygen therapy in adults with COPD or ILD but also highlight the need for additional research to guide clinical practice.