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COPD with chronic hypoxaemia — SCE Respiratory MCQ

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ModerateCOPDCOPD with chronic hypoxaemiaSCE Respiratory

A 68-year-old ex-smoker with COPD is assessed 8 weeks after an infective exacerbation. He has stopped smoking. Resting room-air ABG shows pH 7.39, PaO2 7.1 kPa and PaCO2 5.9 kPa on two occasions 3 weeks apart. FEV1 is 34% predicted and he has ankle oedema but no acute infection. What is the most appropriate management?

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Correct answer: D — Offer ambulatory oxygen after a 6-minute walk test

Persistent stable hypoxaemia with PaO2 at or below 7.3 kPa meets criteria for LTOT assessment and prescription when confirmed in a stable state. Ambulatory oxygen is for exertional desaturation and does not replace LTOT in severe resting hypoxaemia. CPAP is not the treatment for isolated COPD-related hypoxaemia, and nebulisers or surgery do not address the mortality benefit associated with LTOT.

Reference: NICE NG115 COPD; BTS Home Oxygen Guideline