Introduction
Oxygen therapy is the use of supplemental oxygen to treat patients with chronic obstructive pulmonary disease (COPD). COPD is a progressive lung disease that makes it difficult to breathe. When the airways in the lungs become narrowed and irritated, less oxygen enters the blood. This insufficient oxygen in the blood can cause shortness of breath, wheezing, and chest tightness. Oxygen therapy can help relieve these symptoms by delivering supplemental oxygen to the lungs. It can additionally aid in improving life quality and extend the patient’s life expectancy. COPD patients need to learn about the benefits of oxygen therapy because it can be a life-saving treatment for some COPD patients.
However, oxygen therapy is also associated with risks; therefore, COPD patients need to understand its benefits and risks before starting treatment. There are several types of oxygen therapy, and it is essential to understand the guidelines for each type to ensure that patients receive the most effective treatment. For example, there are different guidelines for using these oxygen therapies on COPD patients. It is equally advised for medics to be aware of the risks associated with oxygen therapy so that patients can be monitored closely for any potential complications. Oxygen therapy has several benefits for COPD patients, as well as key guidelines to be followed to avoid risking patients’ lives.
Oxygen Therapy Benefits
Oxygen therapy has many advantages to COPD, which aids in ensuring better patients outcome. Firstly, increased oxygen levels in the blood can help to improve breathing and reduce shortness of breath. COPD is caused by damage to the lungs over time, usually from smoking. Symptoms include breathing complications such as cough with sputum, frequent respiratory infection, and shortness of breath, especially during physical activities. One way to improve breathing and reduce shortness of breath among COPD patients is to increase the levels of oxygen in their blood. This can be done with supplemental oxygen therapy, which involves using an oxygen machine to increase the amount of oxygen in the patient’s blood. Supplemental oxygen therapy can help improve the quality of life and may even prolong it. A study by Kraemer et al. (2021) found that increased oxygen levels in the blood assist in improving breathing and reducing shortness of breath among COPD patients. The researchers studied a group of COPD patients who were given supplemental oxygen for 12-24 weeks. The study found that the patients who received supplemental oxygen had improved lung function and experienced less shortness of breath.
Secondly, oxygen therapy increases energy levels and overall quality of life. According to Yorke et al. (2018) observation, oxygen therapy patients significantly improved dyspnea, fatigue, and health-related quality of life. This is likely because supplemental oxygen increases the amount of oxygen reaching the tissues, which can help improve cellular function and energy production. Additionally, supplemental oxygen aids in reducing the work of breathing, which can lead to increased energy levels and boosts life quality. The study by Kaymaz et al. (2018) also confirmed that supplemental oxygen therapy improved the quality of life and reduced breathlessness in COPD patients. As Ouellette and Lavoie (2017) explained, long-term oxygen therapy was associated with a significantly reduced risk of death from any cause in COPD patients. The authors similarly reported that an increased flow of oxygen to the brain had beneficial effects on cognitive function and mood in COPD patients.
Thirdly, oxygen therapy can help to reduce the risk of hospitalizations and emergency room visits. When a patient is oxygen-deprived, their body has to work harder to pump blood throughout the body, which can lead to heart problems (Gershon et al., 2018). When patients have access to oxygen therapy, their body does not have to work as hard to get oxygen to the cells, which can aid in improving the function of the heart and other organs.
In addition, supplemental oxygen therapy can help fight infection and reduce inflammation. All of these factors can help prevent hospitalizations and emergency room visits. The study by Ballestero et al. (2018) also found that oxygen therapy can help to reduce the risk of hospitalizations and emergency room visits in patients with chronic obstructive pulmonary disease (COPD). The study likewise mentioned that those who received supplemental oxygen for two hours per day were less likely to require hospitalization or visit the emergency room than those who did not receive oxygen therapy. The findings suggest that oxygen therapy is one of the most critical parts of treatment for COPD patients.
Similarly, oxygen therapy may help to slow the progression of COPD by helping to keep the airways open. This treatment can be delivered in several ways, including through a face mask, nasal prongs, or a tube inserted down the windpipe (endotracheal tube). It is often recommended for people with COPD who have low oxygen levels in their blood (hypoxemia) (O’Driscoll et al., 2017). Oxygen therapy can help to improve breathing and reduce shortness of breath., as well as the quality of life and increase survival rates in people with COPD.
Risks of Oxygen Therapy
As much as oxygen therapy has its benefits, it as well has its disadvantages for COPD patients. Some patients with respiratory symptoms may find their condition worsening due to using oxygen therapy. This is because supplemental oxygen may add to the inflammation and oxidative stress level in the body, potentially leading to more serious problems (Gonçalves and Romeiro, 2019). In some cases, it may even be necessary to reduce the amount of oxygen used or discontinue its use altogether. According to MacLeod et al. (2021), approximately twenty-five percent of patients who use oxygen therapy develop respiratory symptoms, such as increased coughing and wheezing, that may necessitate a decrease or cessation of therapy. The authors also found that patients who are hospitalized for an exacerbation of their COPD condition are at especially high risk for developing these symptoms. However, it is important to note that these symptoms can usually be managed successfully with a change in therapy or dosage.
Potentially serious risks associated with oxygen therapy include the development of hypoxemia and hypercapnia. Hypoxemia is a medical condition in which there is not enough oxygen in the blood. This can happen when a person breathes room air that has a low concentration of oxygen, as can occur when using supplemental oxygen at high altitudes. Hypercapnia is a condition in which there is too much carbon dioxide in the blood (Malli et al., 2019). This may occur when using supplemental oxygen to treat COPD, as increased levels of carbon dioxide can accumulate if the underlying problem (such as COPD) is not corrected.
Furthermore, both hypoxemia and hypercapnia can be dangerous and, if left untreated, may lead to respiratory failure and death. Research by Malli et al. (2019) found that oxygen therapy may be harmful in certain cases, causing hypoxemia and hypercapnia among patients. The research included a total of twenty-three participants and was conducted in one trial. While the study reported some evidence that oxygen therapy may benefit people with COPD and heart failure, it also found evidence that oxygen therapy can cause harm. As a result, the authors cautioned that oxygen therapy should only be used in specific cases and after careful consideration of the risks and benefits. The main risk of developing oxygen tolerance and dependency among patients with COPD as a result of using oxygen therapy is that the body becomes limited and less able to function without supplemental oxygen. This means that over time, patients may need higher and higher doses of oxygen to breathe normally, which can be both expensive and inconvenient.
Additionally, there is always the risk that patients will become too reliant on oxygen that they will forget how to breathe on their own, which can lead to serious health problems or even death. Khor et al. (2017) found that patients with COPD who use oxygen therapy experience a significant increase in their tolerance to oxygen and a decrease in their dependency on oxygen. The study was conducted over a short period and involved twenty-four COPD patients who were randomly assigned to one of two groups (Khor et al., 2017). The first group received regular oxygen therapy, while the second group received supplemental oxygen therapy in addition to regular oxygen therapy. The results of the study showed that the group that received supplemental oxygen therapy had a significant increase in their tolerance to oxygen and a decrease in their dependency on oxygen. The group that only received regular oxygen therapy did not experience any significant changes.
Types of Oxygen Therapy Available
There are a few different types of oxygen therapy available for patients with COPD. One common type is called continuous positive airway pressure, or CPAP therapy (Vanfleteren et al., 2020). This involves wearing a mask that covers the nose and mouth while sleeping. The mask is connected to a machine that sends pressurized air into the lungs to keep them open during sleep. Another common type of oxygen therapy is called short-term intermittent oxygen therapy, or STIO therapy. This entails receiving higher concentrations of oxygen for short periods (usually around two hours) throughout the day (Vanfleteren et al., 2020). This can be done using either a nasal cannula or an oxygen concentrator.
The third type of oxygen therapy is called long-term intermittent oxygen therapy (LTOT). There are many different types of LTOT, but all involve providing supplemental oxygen to a patient for short periods throughout the day (Vanfleteren et al., 2020). This can be done using oxygen tanks, portable concentrators, or nasal cannulas. The length and frequency of oxygen treatments will vary depending on a patient’s individual needs. Above all, LTOT is most recommended over STIO oxygen therapy. One reason for the recommendation is that LTOT delivers oxygen at a lower concentration for a longer period, allowing the patient to breathe more easily and resulting in fewer oxygen desaturations (Ekström et al., 2017). Additionally, LTOT has been shown to improve exercise tolerance, quality of life, and survival rates in patients with COPD.
Oxygen Therapy Guidelines and Cautions
When delivering oxygen therapy to patients with COPD, it is important to adhere to some guidelines. Firstly, physicians should ensure that the patient is sitting upright when oxygen therapy is delivered. This is because when a person is lying down, the diaphragm and other muscles used for breathing cannot work well, which means the lungs cannot take in much oxygen (Jacobs et al., 2018). Sitting upright helps to ensure that the patient gets the most out of their oxygen therapy.
Secondly, the medic should make sure that the flow rate of oxygen is titrated according to the patient’s needs. The flow rate of oxygen should be titrated correctly, as too high or too low flow rates can be harmful. For example, if the flow rate is set too high, it can lead to desaturation and even respiratory failure. On the other hand, if the flow rate is set too low, it can lead to hypoxemia and increased work of breathing for the patient (Malli et al., 2019). Therefore, it is essential that the doctor monitors the patient’s oxygenation levels and adjusts the flow rate accordingly. Thirdly, the doctor must regularly monitor the patient’s condition and adjust the flow rate and/or delivery method as necessary. This will help ensure that they are receiving optimal treatment and minimize any potential risks associated with oxygen therapy.
Furthermore, there are a few contraindications to oxygen therapy, which is why it is advised for patients with COPD to have an accurate diagnosis. For example, patients with chronic heart failure should not be given oxygen therapy, as it can make their condition worse (Yeghiazarians et al., 2021). This is because when too much oxygen is given to these patients, it can cause their blood pressure to drop and their hearts to work harder. This puts a lot of stress on the heart and can ultimately lead to heart failure. Additionally, patients with carbon monoxide poisoning or air embolisms should not be given oxygen therapy (Garg et al., 2018). Carbon monoxide poisoning is a dangerous condition caused by breathing in carbon monoxide gas, while air embolism is a life-threatening medical emergency caused by the entry of air into the vascular system. Carbon monoxide poisoning and air embolisms can cause pulmonary hypertension, which is a condition in which the pressure in the arteries that carry blood from the heart to the lungs (pulmonary arteries) becomes too high.
This increased pressure can damage the delicate tissues of the lungs and lead to lung failure. Oxygen therapy can worsen pulmonary hypertension by increasing the amount of oxygen in the blood. This increase in oxygen can further damage the tissues of the lungs and lead to rapid deterioration in a patient’s condition (Garg et al., 2018). For this reason, carbon monoxide poisoning and air embolism patients should not be given oxygen therapy unless it is necessary.
Conclusion
In conclusion, oxygen therapy has been shown to improve the quality of life and exercise tolerance in patients with COPD. It can be given as supplemental oxygen or through a long-term oxygen therapy device. Benefits of oxygen therapy include improved breathing, reduced shortness of breath, and improved comfort. Although oxygen therapy is safe and beneficial for the majority of COPD patients, a small percentage of patients may develop oxygen tolerance and dependency. In addition, some patients may experience episodes of hypoxemia or hypercapnia that can potentially lead to serious health complications. It is important for healthcare providers to assess each patient’s risk factors before starting oxygen therapy and to monitor these patients closely for any signs or symptoms of adverse reactions. Guidelines for oxygen therapy vary depending on the patient’s condition and symptoms. Types of oxygen therapies available include supplemental oxygen, long-term oxygen therapy, short-term oxygen therapy, and continuous positive airway pressure.
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