Oxygen therapy is widely used in the management of a number of chronic and acute health conditions. The therapy may be used in a hospital setting or pre-hospital setting (e.g. in the ambulance) to manage emergency situations or in the home setting to manage long-term health conditions. The mode of delivery and device used for oxygen therapy depends upon several factors including the patient’s specific needs and the opinion of the medical professionals involved.

Use in the chronic settingSome of the indications for oxygen therapy are described below.

• The therapy may be used to deliver supplemental oxygen to patients with chronic obstructive pulmonary disease (COPD) on a long-term basis. COPD is one of the long-term effects of smoking and patients may need additional oxygen, either through periods where their condition has worsened or as a permanent support throughout the day and night. The use of supplemental oxygen is indicated when a patient with COPD has a partial pressure of oxygen (PaO2) level of 55 mmHg or less or an oxygen saturation (SaO2) level of 88% or less. The therapy has been shown to significantly increase patients’ lifespan.

Other examples of chronic conditions that may benefit from oxygen therapy include:

• Chronic asthma
• Cystic fibrosis
• Pulmonary hypertension
• Obstructive sleep apnea
• Heart failure

Use in the acute setting

• During a medical emergency, oxygen therapy is often used both in the hospital setting and by first aiders in the ambulance while a patient is in transit. In the pre-hospital setting, high flow oxygen therapy may be administered as part of resuscitation or in the case of anaphylaxis, major trauma, seizure or hypothermia, for example.
• In cases where injury or illness has caused hypoxemia, oxygen therapy may be used to increase the availability of oxygen to bodily tissues until target oxygen saturation levels are achieved, based on pulse oximetry testing. The target level for most patients is 94-98% and for those with COPD, the level is 88-92%.