Curriculum · Respiratory
Reassessment of home oxygen after hospital discharge
What it is
Home oxygen arranged on discharge is a temporary prescription, not a permanent one. Hypoxemia following an acute illness is often short-lived, and as many as half the patients prescribed home oxygen on discharge from the hospital will not meet criteria supporting continuation after 3 months. Two things are asked before the prescription is renewed: first, whether the patient has recently been hospitalized for an acute illness; second, what the oxygen saturation is on room air once the patient has been assessed for ongoing hypoxemia. For that group there is no apparent benefit from supplemental oxygen once their oxygen saturation is 88% or greater on room air.
How it is diagnosed
The American Thoracic Society and the American College of Chest Physicians hold that prescriptions for supplemental home oxygen should not be renewed for patients who have recently been hospitalized for acute illnesses without assessing them for ongoing hypoxemia. The measurement that settles it is the oxygen saturation on room air, taken after the patient has been off oxygen long enough to be off it, an hour in one described example. Arterial blood gas studies are not what is needed first.