AARC GUIDELINES: Oxygen therapy in the acute care facility (2002). Respir Care, 47, 6, 717–720
www.rcjournal.com/cpgs/otachcpg-update.html

AARC GUIDELINES: Oxygen therapy in the home or alternate site health care facility (2007). Respir Care, 52, 1, 1063-8
www.rcjournal.com/cpgs/pdf/08.07.1063.pdf

BTS GUIDELINES: O'Driscoll BR, Howard LS, Davison AG (2008) BTS guideline for emergency oxygen use in adult patients. Thorax, 63, Suppl.VI, vi1–68
www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/Emergency%20Oxygen/Emergency%20oxygen%20guideline/Appendix%201%20Summary%20of%20recommendations.pdf
• excellent and comprehensive, including target saturation required for different patients

IMPRESS GUIDELINES on rationalising oxygen use:
www.impressresp.com/LinkClick.aspx?fileticket=Dxoul2o3KZs%3d&tabid=77


Abernethy AP, McDonald CF, Frith PA (2010) Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial. Lancet, 376, 9743, 784-93
www.ncbi.nlm.nih.gov/pubmed/20816546
• oxygen does not relieve breathlessness

Agarwal R, Gupta D (2005) What are high-flow and low-flow oxygen delivery systems? Stroke, 36, 2066-7
stroke.ahajournals.org/content/36/10/2066.2.full#xref-ref-4-1
• letter clarifying the difference between flow and percentage.

Austin MA, Wills KE (2010) Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting. BMJ, 341, c5462
www.bmj.com/content/341/bmj.c5462.full
• titrated oxygen by nasal cannulae in acute COPD patients lowers mortality compared to uncontrolled oxygen via non-rebreather face mask

Benditt JO (2000) Adverse effects of low-flow oxygen therapy. Respir Care, 45, 54-61

Bolton CE, Annandale JA (2006) Comparison of an oxygen concentrator and wall oxygen in the assessment of patients undergoing long term oxygen therapy assessment. Chron Respir Dis. 3, 49-51
• assessment for LTOT must be with the same delivery device that is to be used at home

Booth S (2004) The use of oxygen in the palliation of breathlessness. A report of the expert working group of the scientific committee of the association of palliative medicine. Resp Med, 98, 66-77
www.sciencedirect.com/science?_ob=ArticleURL&_aset=V-WA-A-W-W-MsSAYWW-UUA-U-AAWAUDDBYZ-AAAYZCYAYZ-AZCDZADEB-W-U&_rdoc=1&_fmt=summary&_udi=B6WWS-49SNBV4-1&_coverDate=01%2F31%2F2004&_cdi=7138&_orig=search&_st=13&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6ac62da1693b520bc2d55a0954bf224e
• there is a little evidence for oxygen relieving SOB; a formal assessment must be made to ensure it reduces breathlessness and improves quality of life

Casanova C (2006) Twenty-four-hour ambulatory oximetry monitoring in COPD patients with moderate hypoxemia. Respir Care, 51, 12, 1416-23
• twenty-four hour oximetry is required because of the difference in diurnal desaturations

Celli BR et al (2004) Standards for the diagnosis & treatment of patients with COPD: summary of the ATS/ERS position paper. Eur Respir J, 23, 932 - 46

Chadha TS (1983) Noninvasive treatment of pneumothorax with oxygen inhalation. Respiration, 44, 147-52
• pneumothorax of less than 30% resolves 3 times quicker with high percentage oxygen

Cohen AS, Burns B, Goadsby PJ (2009) High-flow oxygen for treatment of cluster headache. JAMA, 302, 22, 2451-2457
jama.ama-assn.org/cgi/content/full/302/22/2451
• high-flow oxygen facilitates pain relief at 15 minutes

Cranston J et al (2008) Oxygen therapy for dyspnoea in adults. Cochrane Database of Systematic Reviews, Issue 3.

Cullen DL, Koss JA (2004) A comparison of oxygen tubing lengths and flow output with home oxygen equipment. Eur Respir J, 24: Suppl. 48, 517s
www.ersnet.org/ers/lr/browse/media.aspx?id_dossier=17650&id_fiche=122837
• flowrate for long-term oxygen needs to be increased as tubing length increases

Cullen DL (2006) Long term oxygen therapy adherence and COPD: what we don't know. Chron Respir Dis, 3, 217-22
• adherence to home oxygen ranges from 45% to 70%

Dodd ME (2002) Delivering oxygen in hospital and at home. ACPRC Journal, 34, 10-14

Foust GN (1991) Shortcomings of using two jet nebulizers in tandem with an aerosol face mask for optimal oxygen therapy. Chest, 99, 1346-51

Gomersall GD et al (2002) Oxygen therapy for hypercapnic patients with COPD and acute respiratory failure. Crit Care Med, 30, 113-116

Gorecka D (2005) Liquid oxygen, is it the gold standard? Chr Respir Dis, 2, 181-2
• portable liquid oxygen improves compliance and quality of life, but is expensive.

Groves N, Tobin A (2007) High flow nasal oxygen generates positive airway pressure in adult volunteers. Austr Crit Care, 20, 4, 126-131
www.sciencedirect.com/science?_ob=ArticleURL&_udi=B8CX6-4PVY33M-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1093803533&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0475c111376f331564bbc12057c24296
• CPAP generated by high-flow nasal oxygen

Hale KE, Gavin C, O'Driscoll BR (2008) Audit of oxygen use in emergency ambulances and in a hospital emergency department. Emerg Med J, 25(11): 773–6
emj.bmj.com/cgi/content/full/25/11/773
• oxygen is underused in critical illness

Hnatiuk OW (1998) Delivery of high concentrations of inspired oxygen via Tusk mask. Crit Care Med, 26, 1032-5.
• Tusk mask delivers higher concentration oxygen than non-rebreather mask

Janaudis-Ferreira T (2009) Differences in training effects following training with and without supplemental oxygen in patients with COPD. Advances in Physiotherapy, 11 (4): 186-92

Kacmarek RM (2000) Delivery systems for long-term oxygen therapy. Respir.Care, 45, 84-92

Kelly C, Lynes D (2008) The use of domiciliary oxygen therapy. Nurs Times; 104: 23, 46–48.
www.nursingtimes.net/nursing-practice-clinical-research/the-use-of-domiciliary-oxygen-therapy/1543270.article
• overview of indications, assessment and practicalities.

Knighton DR, Fiegel VD, Halverson T (1990) Oxygen as an antibiotic. Arch Surg, 125, 1, 97-100
archsurg.ama-assn.org/cgi/content/abstract/125/1/97

Kuffler DP (2010) Hyperbaric oxygen therapy. J Wound Care, 19, 2, 77-9

Lavery GG (1999) Fear of hypercapnia is leading to inadequate oxygen treatment. Br Med J, 318, 872 (letter)
www.bmj.com/cgi/content/full/318/7187/872?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=318&firstpage=872&resourcetype=HWCIT

Leach RM, Bateman NT (1993) Acute oxygen therapy. Br J Hosp Med. 49, 637-44
• good clear explanation of different masks
• type II RF occurs in 10-15% of acute COPD patients
• flow rates < 5 L/min can cause rebreathing of exhaled CO2

Lewko A (2007) Ambulatory oxygen therapy assessment. Physiotherapy, 93, 261-6

Little SA, Elkholy MM, Chalmers GW (1999) Predictors of nocturnal oxygen desaturation in patients with COPD. Resp Med, 93, 202-7
• nocturnal desaturation is likely if daytime SaO2 is below 93%

Lund J (1996) Nasal cannula versus Hudson facemask in oxygen therapy. J Danish Med Ass, 158, 28, 4077-9
• nasal cannulae usually deliver more oxygen than a Hudson simple mask, but patients vary

Mulloy E (1996) Ventilation and gas exchange during sleep and exercise in severe COPD. Chest, 109, 387-94.
• saturation falls twice as much during sleep as during maximal exercise

Murphy R (2001) Emergency oxygen therapy for the COPD patient. Emerg Med J, 18, 333 - 9.
emj.bmjjournals.com/cgi/content/full/18/5/333?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1095062736981_49&stored_search=&FIRSTINDEX=0&sortspec=relevance&volume=18&firstpage=333&resourcetype=1&journalcode=emermed
• literature review on how much oxygen is OK for COPD patients, easy reading due to key point summaries

Murphy R, Mackway-Jones K, Sammy I et al (2001) Emergency oxygen therapy for the breathless patient. Emerg Med J, 18, 421-3
emj.bmjjournals.com/cgi/content/full/18/6/421

O'Driscoll BR (2011) Safe use of emergency oxygen in chronic respiratory disease. Chron Respir Dis, 8, 159-161.
crd.sagepub.com/content/8/3/159.full.pdf+html?etoc
• oxygen for acute-on-chronic lung disease: COPD, asthma, CF, restrictive disease, lung cancer

Parke R, McGuiness S, Eccleston M (2009) Nasal high-flow therapy delivers low level positive airway pressure. Br J Anaesth, 103, 6, 886-90
• low-level CPAP of 2.7 cmH2O can be provided with high-flow oxygen at 35 L/min with mouth closed

Rees PJ, Dudley F (1998) Oxygen therapy in chronic lung disease. Br Med J, 317, 871-4
bmj.bmjjournals.com/cgi/content/full/317/7162/871?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1088118884210_16994&stored_search=&FIRSTINDEX=0&sortspec=relevance&volume=317&firstpage=871&resourcetype=1,2,3,4

Revill SM, Noor NZ, Butcher G (2010) The endurance shuttle walk test: An alternative to the six-minute walk test for the assessment of ambulatory oxygen. Chronic Resp Dis, 7, 4, 239-45
crd.sagepub.com/content/7/4/239.abstract?rss=1
• the endurance shuttle walk test is more responsive than the six-minute distance for detecting improvements in walking endurance with ambulatory oxygen

Roeckl-Wiedmann I (2005) Systematic review of hyperbaric oxygen in the management of chronic wounds. Br J Surg, 92, 24-32
www.bjs.co.uk/bjsCda/cda/microJournalArticleDetail.do;jsessionid=11E054B22FF5164FAF1E1E6AD53F79A0?DOI=10.1002%2Fbjs.4863&issueDOI=10.1002%2Fbjs.v92%3A1&vid=2
• hyperbaric oxygen helps heal diabetic ulcers

Roffe C, Sills S, Halim M et al (2003) Unexpected hypoxia in patients with acute stroke. Stroke, 34, 2641-5
• hypoxia is common with acute CVA, due to altered respiratory drive, aspiration, weakness and a 44-95% incidence of sleep disorders

Roffe C, Frohnhafen H, Sills S et al (2010) Frequency of nocturnal hypoxia in clinically stable patients during stroke rehabilitation. Clin Rehabil, 24, 267-75
• nocturnal desaturations are common in stable stroke patients.

Royse CF (1997) The effect of supplemental oxygen on hypoxaemia after premedication in cardiac surgery. Anaesth Int Care, 25, 347-9
• if heavy sedation occurs after premed prior to heart surgery, oxygen can be given


Sim MAB, Dean P, Kinsella J (2008) Performance of oxygen delivery devices when the breathing pattern of respiratory failure is simulated. Anaesthesia, 63, 938-40.
• the typical breathing pattern adopted in respiratory failure leads to reduced FiO2.

Tarrega J (2002) Are daytime arterial blood gases a good reflection of nighttime gas exchange in patients on long-term oxygen therapy? Respir Care, 47, 882-6
• daytime ABG’s do not reflect night ABG’s, but early-morning ABG’s do reflect night ABG’s

Uronis HE, Currow DC, McCrory DC, et al (2008) Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis. Br J Cancer, 98, 2, 294–9
• there is no evidence for oxygen relieving SOB at the end of life.

Vos PJE, Folgering HThM, (1995) Predictors for nocturnal hypoxaemia in normoxic and mildly hypoxic patients with COPD. Eur Resp J, 8, 74-7
• patients may have normal arterial blood gases by day but desaturate below 90% at night

Wettstein RB Shelledy DCV, Peters JI (2005) Delivered oxygen concentrations using low-flow and high-flow nasal cannulas. Resp Care, 50, 5, 604-9
www.rcjournal.com/contents/05.05/05.05.0604.pdf
• FiO2 increases with increasing flow
• there is greater FiO2 with mouth closed.

Young P (2005) Ambulatory and training oxygen: a review of the evidence and guidelines for prescription. NZ J Physiother, 33, 1, 7-12
• everything you always wanted to know about oxygen prescription for both exercise training and home use - succinct and evidence-based.


AARC = American Association for Respiratory Care
ABG = arterial blood gas
ACPRC = Association of Chartered Physiotherapists in Respiratory Care
ATS = American Thoracic Society
BTS = British Thoracic Society
CF = cystic fibrosis
ERS = European Respiratory Society
FiO2 = fraction of inspired oxygen concentration
ILD = interstitial lung disease
JAMA = Journal of American Medical Association
LTOT = long term oxygen therapy
SOB = shortness of breath