Oxygen: The Kiss of Life

Recent guidelines emphasize the importance of an active life for COPD patients, including those with chronic respiratory failure.2 Oxygen supplementation increases exercise performances and prevents oxygen desaturation during daily activities in patients with “overt” or “latent” chronic respiratory failure.3 This highlights the importance of correctly titrating home oxygen flow for when these patients are at home and/or performing an outdoor activity. The prescription of long-term oxygen therapy and the titration of the flow rate are based either on resting PaO2 or exertional desaturation, usually assessed during the 6-min walk test, which does not necessarily mimic real-life situations.4 Several conditions may require different oxygen flows,5 and some of them are “involuntary” or “mandatory,” such as sleeping, defecating,6 eating, and digestion, whereas some others are “voluntary,” such as walking, gardening, cooking, traveling, sex, and even watching television. If, during these activities, oxygen desaturations are not adequately corrected, they may result in cardiac arrhythmia and eventually transient pulmonary hypertension that may harm the patient’s life.