Treatment of Dyspnea: Oxygen

It is appropriate to give oxygen to hypoxic patients with dyspnea. However, caution should be used in patients with COPD, as you can suppress the respiratory drive in chronic CO2 retainers, and therefore giving oxygen with a goal saturation of 90% is an appropriate first step.

Oxygen therapy in palliative care

  • Think of oxygen as any other drug- not all dyspneic patients benefit
  • Pulse oximetry will generally not be of benefit in decision-making for treating terminal dyspnea
  • Masks and positive pressure devices are poorly tolerated; use nasal cannula
  • Near the end of life, use 2-4 liters O2; for continued dyspnea use drug therapy rather than using higher flow rates or face mask.

Recommended readings

Currow DC, Agar M, Smith J, Abernethy AP. Does palliative home oxygen improve dyspnoea? A consecutive cohort study. Palliat Med. 2009 Jun;23(4):309-16. Epub 2009 Mar 20.