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COPD LTOT Criteria — RACP Adult Medicine MCQ

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ModerateRespiratoryCOPD LTOT CriteriaRACP Adult Medicine

A 58-year-old man with COPD on home oxygen therapy is found to have a resting PaO₂ of 52 mmHg on room air. According to Australian guidelines, what are the criteria for prescribing long-term oxygen therapy (LTOT)?

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Correct answer: D — PaO₂ <55 mmHg OR PaO₂ 55–59 mmHg with evidence of end-organ damage

LTOT is indicated for patients with chronic stable hypoxaemia and PaO₂ ≤55 mmHg on two measurements at least 3 weeks apart, OR PaO₂ 56–59 mmHg with evidence of end-organ consequences (pulmonary hypertension, cor pulmonale, polycythaemia with haematocrit >55%). LTOT must be used for ≥15 hours/day to improve survival (MRC and NOTT trials). The COPD-X guidelines align with these criteria.

Reference: Lung Foundation Australia/TSANZ – 2025 – COPD-X Plan; TSANZ – 2015 – LTOT Position Statement