Oxygen Treatment for Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is one of the biggest threats to public health of the twenty-first century according to estimates placing it third only to heart diseases and cancer as a killer. This progressive respiratory condition is present in about 384 million people worldwide with prevalence rates increasing because of the aging of the population and environmental exposures. The disease burden is not just limited to the mortality rates but the disease tends to be complicated resulting in more admissions to hospitals and bringing a huge economic burden in terms of health care costs and family expenses. Oxygen therapy has become one of the mainstays in the treatment of COPD, especially in patients with severe COPD and chronic hypoxemia. The basis of oxygen therapy is aimed at reversing hypoxemia, decreasing the work of breathing, and refers to the reduction of the burden on the cardiovascular system (Zhang et al., 2023). The evidence for using oxygen therapy in COPD patients started from the Medical Research Council and Nocturnal Oxygen Therapy Trial conducted in the 1980s which testified oxygen therapy as one of the few treatments that can raise life expectancy in COPD patients with severe hypoxemia. Today's clinical practice guidelines, including the GOLD document, urge doctors to prescribe long-term oxygen therapy to patients with specific criteria. These recommendations have been established from research findings showing that properly chosen patients suffering from heart failure benefit from such approaches through increased life span, less hospitalization, and improved quality of life. However, it is clear that oxygen therapy is patient and context-specific and that there are several potential barriers to the optimal use of oxygen therapy.