What is the role of oxygen supplementation in the management of pulmonary arterial hypertension (PAH)?

Updated: Apr 25, 2018
  • Author: Kristin E Schwab, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Oxygen has proved beneficial for reducing patient mortality in selected patients with pulmonary hypertension. Two large trials demonstrated a definite mortality benefit for patients with WHO group 3 pulmonary hypertension secondary to chronic obstructive pulmonary disease (COPD). Although long-term study results are not available for other WHO groups, it appears that oxygen administration likely benefits these other groups as well. Accordingly, long-term oxygen therapy should be prescribed for patients whose arterial oxygen tension (PaO2) is lower than 55 mm Hg at rest from any cause, those who have desaturation during exercise, and those who perform better on oxygen therapy.

Medicare indications for continuous long-term oxygen therapy include the following:

  • PaO 2 of 55 mm Hg or less, or oxygen saturation (SaO 2) of 88% or less
  • PaO 2 of 56-59 mm Hg or SaO 2 of 89%, in the presence of evidence of cor pulmonale, right-sided heart failure, or erythrocytosis (hematocrit >55%).

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