Evidence-based On-call

Exacerbation of Chronic Obstructive Pulmonary Disease

Prevention

Consider home oxygen in patients with severe hypoxia (pO₂ < 7.5 kPa or < 8.0 kPa with oedema ) ^a given continuously ^a

Why?

It reduces mortality ^a if given continuously ^a
There is no clear reduction in mortality for patients with moderate hypoxia or nocturnal sleep desaturation ^d

Home oxygen reduces mortality in patients with severe hypoxia

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
COPD with severe hypoxia ^a	home oxygen	no oxygen	death at 5 years	67%	0.42 (0.18 to 0.98)	5 (2 to 98)
	continuous oxygen	oxygen at night	death at 2 years	40%	0.45 (0.25 to 0.81)	5 (3 to 11)