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Review
. 2022 Nov 4;48(5):e20220179.
doi: 10.36416/1806-3756/e20220179. eCollection 2022.

2022 Brazilian Thoracic Association recommendations for long-term home oxygen therapy

[Article in English, Portuguese]
Maria Vera Cruz de Oliveira Castellano  1 , Luiz Fernando Ferreira Pereira  2 , Paulo Henrique Ramos Feitosa  3 , Marli Maria Knorst  4   5 , Carolina Salim  6   7 , Mauri Monteiro Rodrigues  1 , Eloara Vieira Machado Ferreira  8 , Ricardo Luiz de Menezes Duarte  9 , Sonia Maria Togeiro  10 , Lícia Zanol Lorencini Stanzani  3 , Pedro Medeiros Júnior  6 , Karime Nadaf de Melo Schelini  11 , Liana Sousa Coelho  12 , Thiago Lins Fagundes de Sousa  13 , Marina Buarque de Almeida  14 , Alfonso Eduardo Alvarez  15
Affiliations
Review

2022 Brazilian Thoracic Association recommendations for long-term home oxygen therapy

[Article in English, Portuguese]
Maria Vera Cruz de Oliveira Castellano et al. J Bras Pneumol. .

Abstract
in English, Portuguese

Some chronic respiratory diseases can cause hypoxemia and, in such cases, long-term home oxygen therapy (LTOT) is indicated as a treatment option primarily to improve patient quality of life and life expectancy. Home oxygen has been used for more than 70 years, and support for LTOT is based on two studies from the 1980s that demonstrated that oxygen use improves survival in patients with COPD. There is evidence that LTOT has other beneficial effects such as improved cognitive function, improved exercise capacity, and reduced hospitalizations. LTOT is indicated in other respiratory diseases that cause hypoxemia, on the basis of the same criteria as those used for COPD. There has been an increase in the use of LTOT, probably because of increased life expectancy and a higher prevalence of chronic respiratory diseases, as well as greater availability of LTOT in the health care system. The first Brazilian Thoracic Association consensus statement on LTOT was published in 2000. Twenty-two years later, we present this updated version. This document is a nonsystematic review of the literature, conducted by pulmonologists who evaluated scientific evidence and international guidelines on LTOT in the various diseases that cause hypoxemia and in specific situations (i.e., exercise, sleep, and air travel). These recommendations, produced with a view to clinical practice, contain several charts with information on indications for LTOT, oxygen sources, accessories, strategies for improved efficiency and effectiveness, and recommendations for the safe use of LTOT, as well as a LTOT prescribing model.

Algumas doenças respiratórias crônicas podem evoluir com hipoxemia e, nessas situações, a oxigenoterapia domiciliar prolongada (ODP) está indicada como opção terapêutica com o objetivo principal de melhorar a qualidade e a expectativa de vida desses pacientes. O oxigênio domiciliar é usado há mais de 70 anos, e a ODP tem como base dois estudos da década de oitenta que demonstraram que o uso de oxigênio melhora a sobrevida de pacientes com DPOC. Existem evidências de que a ODP tem outros efeitos benéficos como melhora da função cognitiva e da capacidade de exercício e redução de hospitalizações. A ODP está indicada para outras doenças respiratórias que cursam com hipoxemia, segundo os mesmos critérios estabelecidos para a DPOC. Tem sido observado aumento no uso da ODP provavelmente pela maior expectativa de vida, maior prevalência de doenças respiratórias crônicas e maior disponibilidade de ODP no sistema de saúde. O primeiro consenso sobre ODP da Sociedade Brasileira de Pneumologia e Tisiologia foi publicado em 2000; após 22 anos, apresentamos esta versão atualizada. Este documento é uma revisão não sistemática da literatura, realizada por pneumologistas que avaliaram evidências científicas e diretrizes internacionais sobre ODP nas diversas doenças que cursam com hipoxemia e em situações específicas (exercício, sono e viagens aéreas). Estas recomendações, tendo em vista a prática clínica, oferecem diversos quadros com informações sobre indicações, fontes de oxigênio, acessórios e estratégias para melhor eficiência, efetividade e uso seguro da ODP, assim como um modelo para sua prescrição.

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Conflict of interest statement

CONFLICTS OF INTEREST: None declared.

Figures

Figure 1
Figure 1. Examples of medical certificates requested by airlines to prove that the passenger is fit to fly: the Medical Information Form (MEDIF) and the Frequent Traveller’s Medical Card (FREMEC).
Chart 1
Chart 1. Indications for home oxygen therapy.a
Chart 2
Chart 2. Sources of high-pressure oxygen.a
Chart 3
Chart 3. Sources of liquid oxygen (stored at −183°C; 1 L of liquid oxygen = 860 L of gaseous oxygen).a
Chart 4
Chart 4. Oxygen concentrators (oxygen from room air).a
Chart 5
Chart 5. Devices and accessories for long-term home oxygen therapy.a
Chart 6
Chart 6. Strategies to improve the efficacy of long-term home oxygen therapy.
Chart 7
Chart 7. Recommendations for the safe use of oxygen.a
Chart 8
Chart 8. Protocols for the use of long-term home oxygen therapy: key points.
Chart 9
Chart 9. Oxygen therapy during air travel.a,b
Chart 10
Chart 10. Long-term home oxygen therapy. International guideline recommendations.a
See this image and copyright information in PMC

References

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