Ambulatory oxygen therapy

This is oxygen carried by the patient, either as a lightweight cylinder of gaseous oxygen, or a liquid oxygen cylinder, and used on exercise. The aim of ambulatory oxygen therapy is to increase exercise tolerance and reduce breathlessness on exercise. Its main purpose is not to increase the hours of use of LTOT, nor to correct life-threatening hypoxaemia, although these may be reasons for use in some patients.

Assessment and rational prescribing of LTOT, short-burst therapy, or ambulatory oxygen all need to be based on the different objectives for use in each of these situations, where there is evidence to support the practice. The UK Department of Health commissioned the Royal College of Physicians of London to produce clinical guidelines and advice for prescribers in the UK on domiciliary oxygen therapy services in COPD and other diseases, which were published in 1999 [3]. These comprehensive guidelines cover LTOT, short-burst therapy and ambulatory therapy. The guidelines for LTOT, which are largely evidence-based, have hardly changed since the original guidelines for the prescription of domiciliary oxygen concentrators were introduced in 1985. In contrast, many of the recommendations — particularly relating to short-burst therapy and ambulatory oxygen — are largely based on consensus expert opinion, as is acknowledged in the report.

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