Oxygen Therapy

Oxygen therapy is a type of treatment used by some people with chronic obstructive pulmonary disease (COPD). It is sometimes called supplemental oxygen.1

COPD causes lung damage that can keep the lungs from being able to absorb enough oxygen. If the body does not have enough oxygen, it cannot function as well as it should. Oxygen therapy delivers an extra supply of oxygen into the body that can help improve symptoms of COPD. Not everyone with COPD needs oxygen therapy, but it is part of the treatment plan for many patients.1,2

How can oxygen therapy help relieve the symptoms of COPD?

Oxygen therapy can help some people with COPD to feel better and be more active. Because it increases the amount of oxygen in a patient’s body, it can help to:

  • Decrease breathlessness
  • Decrease fatigue
  • Improve mental alertness and mood
  • Improve sleep quality2,3

When do COPD patients need oxygen therapy?

COPD patients may be prescribed oxygen therapy if the level of oxygen in their bloodstream is too low.2 Feeling breathless is not a sure way of telling that a patient is not getting enough oxygen. This has to be done using a blood test to measure the level of oxygen. Healthcare professionals use blood-oxygen tests such as:

  • Arterial blood gas test
  • Pulse oximetry test

The amount of oxygen a patient needs, and how often it should be used, depends upon the results of the blood-oxygen tests. The amount of oxygen a patient needs is called the oxygen flow rate. This describes the number of liters of oxygen that is delivered per minute. The amount a patient needs during exercise or sleeping might be different than the amount they need while at rest.

Sometimes, people with COPD need short-term oxygen therapy to help improve blood oxygen levels that are too low because of a respiratory infection or COPD flare-up, for instance. In those cases, patients may be able to stop oxygen therapy once they have recovered from the infection or flare-up. Some people with COPD may only need oxygen during certain times, like when they are being active or sleeping.

Other people with COPD may need to have long-term oxygen therapy. Long-term means that they need to receive oxygen for 15 to 24 hours every day. This is more common during the later stages of the disease.

People who need long-term oxygen therapy can use portable oxygen delivery units that allow them to be active and take part in many of their usual day-to-day activities. Healthcare providers can help advise about activities that are safe to do while using oxygen.

How is the oxygen supplied?

Oxygen therapy can be carried out at home, or in a hospital or other healthcare location. Long-term oxygen therapy is more likely to take place in the patient’s home.

There are various ways that oxygen can be delivered into a patient’s lungs:

  • Tubes in the nostrils (nasal cannula)
  • Face mask
  • A tube inserted into the trachea (windpipe)1

A nasal cannula is the most common way to receive oxygen. A small tube carries oxygen from a container to two small plastic tubes that are placed in both nostrils. People who need a larger supply of oxygen may need to use a face mask. The mask covers the nose and mouth and is connected to a tube that attaches to the oxygen container. Some people require oxygen directly into the trachea through a small tube that is inserted by a doctor.

Many patients on long-term oxygen therapy receive regular deliveries of oxygen to their homes. The oxygen can be supplied in different kinds of equipment:

  • Compressed oxygen gas
  • Liquid oxygen
  • Oxygen concentrators

Compressed oxygen is a gas that comes in metal cylinders of various sizes. This includes portable units that can be carried in a bag or wheeled around. Liquid oxygen is delivered in large containers from which small portable containers can be filled. Liquid oxygen turns into a gas when it flows out of the container.

Oxygen concentrators remove oxygen from the air by filtering out other gases. This means that they do not need to be refilled. But because they depend on electricity to filter the air, patients still need a back-up supply of oxygen in a different kind of container.

What can patients expect when they start oxygen therapy?

If a patient is getting oxygen therapy at the hospital, then healthcare providers are there to make sure that the right amount of oxygen is being delivered correctly. Patients who are starting oxygen therapy at home will have their equipment set up and shown to them by the oxygen equipment provider. They may also learn more about the therapy at a pulmonary rehabilitation program.

Pure oxygen can be a serious fire hazard. It is important for patients to take steps to make sure that they are safe. Some of the most important safety tips while using oxygen are:

  • Never smoke or be around anyone who is smoking
  • Stay at least 5 feet away from any flame, such as a gas stove or candle
  • Never use oxygen therapy in a small or enclosed space

Are there any side effects of oxygen therapy?

Some patients who use oxygen therapy may have side effects, including:

  • Dry or bloody nose
  • Irritated skin around the cannula or mask
  • Tiredness or drowsiness
  • Morning headaches1

Patients should talk to their doctor about any side effects they are experiencing. Sometimes these side effects can be relieved by:

  • Changing the oxygen delivery equipment
  • Adjusting the amount of oxygen
  • Changing how often oxygen is used
  • Using a humidifier or nasal spray
Written by: Anna Nicholson and Emily Downward | Last reviewed: April 2018.
View References
  1. Oxygen Therapy. National Heart, Lung, and Blood Institute. Available at https://www.nhlbi.nih.gov/health-topics/oxygen-therapy. Accessed 4/3/18.
  2. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease, 2018 Report. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Available at http://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf. Accessed 4/3/18.
  3. How can oxygen therapy help me? American Lung Association. Available at http://www.lung.org/lung-health-and-diseases/lung-procedures-and-tests/oxygen-therapy/how-can-oxygen-help-me.html. Accessed 4/4/18.