By rray, 22 February, 2024 If hypoxemic per SpO2 ABG Assess for long term O2 tx indications SpO2 88 or PaO2 55 mmHg w or w o hypercapnia 2x in 3wk or sat 88 or PaO2 55 60 mmHg w pulm HTN edema suggesting CHF or hct 55 Prescribe O2 for severe resting hypoxemia A
By rray, 22 February, 2024 Air travel If resting sat 95 w 6 min walk sat 84 air travel OK however severe hypoxemia in air travel may occur despite sea level sat C
By rray, 22 February, 2024 If placed on long term O2 titrate to keep sat 90 re evaluate at 60 90 days w pulse ox ABG
By rray, 22 February, 2024 If stable COPD w only moderate resting exercise induced desaturation no benefit to O2 A
By rray, 22 February, 2024 Consider pulmonary rehab A Encourage physical activity improves SOB health status exercise tolerance in stable COPD A reduces hospitalization in pts w recent exac B Optimum benefits seen from 6 to 8 wk program no evidence supports 12wk Twice weekly superv
By rray, 22 February, 2024 Check adherence inhaler technique and possible interfering comorbidities Target exac dyspnea w additional tx Mitigate risks If advanced COPD consider palliative care and end of life support
By rray, 22 February, 2024 Continue short acting BD for sx rescue SAMA ipratropium MDI NEB SABA albuterol levalbuterol MDI NEB for all pts
By rray, 22 February, 2024 If on LABA ICS w o features of asthma If well controlled and no sx continue If further exac If eos 100 cells L treat w LABA LAMA ICS if eos
By rray, 22 February, 2024 If on ICS LAMA LABA triple tx Consider removing ICS if pneumonia or other considerable ADRs If eos 300 cells L de escalation is more likely to lead to exac If FEV1