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For patients with chronic pulmonary or cardiac diseases, there is often a need for oxygen therapy to continue after discharge from hospitalization. Providing oxygen for patients at home has many benefits when given appropriately. This activity describes the indications of home oxygen therapy and highlights the role of the interprofessional team in the management of patients with lung disorders that necessitates home oxygen. Objectives: Identify the indications for home oxygen therapy. Describe the equipment needed for home oxygen therapy. Outline the complications of home oxygen therapy. Describe the importance of improving care coordination among interprofessional team members to improve outcomes for patients with lung disease needing home oxygen therapy. Access free multiple choice questions on this topic.

For patients with chronic pulmonary or cardiac diseases, there is often a need for oxygen therapy to continue after discharge from hospitalization. Providing oxygen for patients at home has many benefits when given appropriately. Oxygen supplementation at home includes: Long-term oxygen therapy (LTOT) in which oxygen is delivered for patients with chronic hypoxemia, for at least 15 hours daily. Ambulatory oxygen therapy (AOT): Oxygen supplementation during exercise and daily activities for patients who are not hypoxemic at rest but who develop hypoxemia on exercise. Nocturnal oxygen therapy (NOT) in which oxygen administered overnight alone with no oxygen therapy during daytime hours. Short burst oxygen in which a brief and intermittent oxygen supplementation used as needed in the absence of hypoxemia. Palliative oxygen therapy (POT): The use of oxygen for relieving breathlessness in advanced or life-limiting disease in the absence of known hypoxemia. These methods of oxygen delivery at home have different degrees of supporting evidence.[1]

There are potential toxicities in patients administered oxygen in high concentrations (above 50%) for long periods like atelectasis, oxidative stress, and peripheral vasoconstriction, but the benefits outweigh the risks. Uncontrolled oxygen delivery may lead to a worsening of hypercapnia in patients with chronic obstructive pulmonary disease. It is advised to target the SpO2 to 90% to 92% to prevent tissue hypoxia while minimizing any side effects, which might be associated with excessive oxygen supplementation. Patients should be made aware of the dangers of using home oxygen in the presence of any naked flame, such as cookers and candles. Oxygen cylinders should be at least 5 feet away from naked flames, a heat source, or electrical devices. There is a significant risk of fire associated with smoking while using home oxygen therapy. Smoking cessation should be advocated. And a written education plan should be given to patients before ordering home oxygen.[11] The skin around the facemask or nasal cannula can get irritated or bruised if the mask fits tightly. The nasal mucosa might become dry, and nosebleeds can occur. Morning headache or tiredness can occur with oxygen therapy.

A respiratory therapist can evaluate and assist patients with their home oxygen needs. The respiratory therapist can provide expertise in the various types of home oxygen delivery devices and provide ongoing assessment of the patient. Patient compliance can be maximized by selecting the appropriate device.[10] Before, referring patients to home oxygen evaluation services, patients should receive both written and verbal information.[1] [Level 4]