Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee; Philipps University Marburg (Schoenau site), German Center for Lung Research (DZL), Marburg; Department for Prevention, Rehabilitation, and Sports Medicine, Technical University Munich (TUM), Munich, Germany.
Dtsch Arztebl Int. 2018 Dec 24;115(51-52):871-877. doi: 10.3238/arztebl.2018.0871.
Long-term oxygen therapy (LTOT) is an established treatment for patients with chronic hypoxemia. Its scientific basis is derived mainly from two trials from the early 1980s that showed a survival advantage for patients with chronic obstructive pulmonary disease (COPD) treated with LTOT. Robust data are not available for other diseases associated with hypoxemia.
This review is based on pertinent publications retrieved by a selective search in PubMed.
The use of LTOT for 15 to 16 hours per day (or, better, 24 hours per day) is recommended in current guidelines for patients with chronic hypoxemia (PaO2 ≤ 55 mm Hg) because this treatment was found to be associated with a lower mortality rate compared to no LTOT (33% vs. 55%, p <0.05) based on data from the early 1980s. In the short term, oxygen administration to a hypoxemic patient can improve oxygen saturation by nine percentage points and improve physical performance to a clinically relevant extent (6-minute walking test: + 37 m, p <0.001). The available data do not support the use of LTOT for normoxemic patients. LTOT should only be administered for strict indications, in accordance with the guidelines, and only in a form suitable for the individual patient. Skin burns can occur as a side effect of LTOT because of contact explosions with any type of fire.
The acquisition of further robust data would be desirable, particularly with respect to patient-relevant outcome parameters including quality of life, performance status, and mortality. Moreover, the German guidelines on oxygen therapy need to be updated.
长期氧疗（LTOT）是治疗慢性低氧血症患者的一种既定疗法。其科学依据主要来自于 20 世纪 80 年代早期的两项试验，这些试验表明，接受 LTOT 的慢性阻塞性肺疾病（COPD）患者具有生存优势。对于其他与低氧血症相关的疾病，尚无确凿数据。
本综述基于在 PubMed 中进行选择性检索获得的相关出版物。
目前的指南建议，对于慢性低氧血症（PaO2≤55mmHg）患者，应每天使用 LTOT 15-16 小时（或更好的 24 小时），因为与不进行 LTOT 相比，这种治疗与较低的死亡率相关（33%对 55%，p<0.05），该数据来源于 20 世纪 80 年代早期。在短期内，给低氧血症患者供氧可使氧饱和度提高 9 个百分点，并在临床上显著改善身体机能（6 分钟步行试验：+37m，p<0.001）。现有数据不支持对氧合正常的患者使用 LTOT。LTOT 只能在符合指南的严格适应证下，并仅在适合个体患者的形式下使用。LTOT 可能会产生皮肤灼伤等副作用，因为它与任何类型的火源接触都会引发爆炸。
希望能获得更多确凿的数据，特别是关于患者相关的预后参数，包括生活质量、功能状态和死亡率。此外，德国的氧疗指南需要更新。
