Expiratory positive pressure oxygen therapy in chronic pulmonary disease.

Abstract

Oxygen therapy is not necessary for all patients who have chronic pulmonary dysfunction. Patients with ventilatory insufficiency do not require oxygen unless there has been progression of their disease or a crisis precipitated by infection, excessive activity, or other causes. Patients who have severer and more advanced impairment of alveolar ventilation or pulmonary dysfunction with cardiac insufficiency, however, do require oxygen. 1 In most instances, differentiation of these severer forms of dysfunction from the ventilatory type can be made by a clinical evaluation that considers at least the following points: (1) history of the disease, its duration and progression; (2) presence or absence of cyanosis at rest or after moderate exercise; (3) presence or absence of orthopnea or paroxysmal dyspnea, especially at night; and (4) nature and degree of disability—the effect of performing simple tasks such as dressing, bathing, talking, and walking. Cardiopulmonary function tests are extremely informative about the