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How can low oxygen level be managed?

Q: My 85 years old grandmother is suffering from chronic obstructive pulmonary disease (COPD). Earlier, she used to experience shortness of breath while walking for long but now she feels shortness of breath while resting. The doctor has prescribed 14 hours of oxygen daily and nebulisation, when required. She underwent these tests – ECHOcardiography, blood sugar, haemoglobin, routine urine. All came normal. Will she be on oxygen life long? How can low oxygen level be managed?

A:It is important to continue oxygen in patients with chronic obstructive pulmonary disease (COPD) since there is evidence that it may prolong the life in patients with low oxygen levels. At the same time you should ask her doctor to see if there is any evidence for carbon dioxide retention since that will affect how much oxygen she should be placed on, especially at night. She should exercise regularly, maintain a healthy diet and get to an optimum weight. In advanced COPD there is the possibility of right sided heart failure with leg swelling and it will be important to see if she has any clinical and echo evidence for this problem. If she produces a lot of phlegm there are certain anti-inflammatory steroid inhalers which may be of help. She must continue to avoid smoke from all sources and other irritants to the air passages. In very advanced conditions the use of a breathing machine at home called BiPAP may be needed. Please share this information with her doctor who will be best able to coordinate her care.

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