A prescription of LTOT is properly considered, because Medicare claims on LTOT prescription only if this therapy is vitally important for patient’s life. In case of such kind of strict regulations it is weird that LTOT is blamed for causing deaths or worsening patient’s quality of life or health status.
Generally speaking, LTOT is a generally accepted and approved treatment for patients with COPD. With regard to the fact that there are different points of view expressed by medicals, critics and researchers concerning LTOT, this research is focused on unprejudiced consideration of this method and discusses both its benefits and negative outcomes. On the one hand, the results of the studies, which have been constantly conducted, witness that LTOT prolongs patient’s life. On the other hand, a poor diagnosis and inexact guidance for this treatment prescription and deaths of some patients prove inconsistency an inappropriateness of LTOT for individuals with COPD:
In COPD patients considered for LTOT, the FEV1 should normally be less than 1.5 IV litres, or less than 40% of predicted normal values. The presence of arterial hypoxaemia with a higher FEV1 suggests that there may be another cause for the hypoxaemia, e.g. sleep apnoea, and further investigations will be required. Patients should be prescribed LTOT for at least 15 h per day, although survival improves when LTOT is used for more than 20 h per day. Thus the hours of LTOT use should not be restricted, especially in severe COPD. There is no benefit in the use of LTOT in COPD patients with a PaO2 above 8 kPa (Tiep, Barnett, Schiffman, 2002).
Benefits of LTOT may be proven by improvement in patients’ lives, quality of patients’ lives, decrease of mortality levels, psychological and cognitive statuses’ perfection etc. In this frame of discussion, it is relevant to mention a study on relationship between heath and quality of life before and after LTOT. The results show that quality of life among