Algorithm A3: Long-Term Oxygen Therapy

Patient with COPD on maximal medical therapy and stable for 30 days [A]
Obtain oximetry
Is SaO2 less than or equal to 90 percent [B] or is FEV1 less than or equal to 35 percent or are there signs of hypoxia? [B] Obtain ABG
Box 3 no to box 12 Is PaO2 less than or equal to 55 mm Hg? [C] Box 5 yes to box 6
Are there signs of tissue hypoxia AND PaO2 is greater than or equal to 56 and less than or equal to 59? [B] Box 7 yes to box 6
If ABGs are available, is PaCO2 greater than or equal to 45 mm HG? [H] Order overnight oximetry and/or exercise oximetry [E] Institute long-term 24-hour oxygen therapy [D]
Box 12 no to box 11 Is SaO2 less than or equal to 88 percent during sleep or exercise? Box 9 yes to box 10
Continue medical care and follow up. Return to Core algorithm [G] Arrange for long-term oxygen therapy during sleep and/or exercise [F]