ATS Publishes Guidelines for Home Oxygen Therapy for Chronic Lung Disease

Home oxygen therapy can be an effective treatment approach for patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). New guidelines published by the American Thoracic Society aim to help guide therapy.

This guideline comes as evidence-based research on appropriate oxygen use for these patients has been lacking. The writing committee of this new guideline used a modified Delphi approach to answer 6 research questions on different uses of oxygen for patients with chronic lung diseases. In addition to the questions, the panel completed a systematic review of literature and the Grading of Recommendations Assessment, Development, and Evaluation to contribute to these new clinical practice recommendations.

As a result, the panel made several recommendations, including:

  • Long-term oxygen use in patients with COPD (moderate-quality evidence) or ILD with severe chronic resting hypoxemia (low-quality evidence) is strongly recommended.
  • For patients with both COPD and moderate chronic resting hypoxemia, the panel made a conditional recommendation against long-term oxygen use.
  • For patients with COPD (moderate-quality evidence) or ILD (low-quality evidence) with severe exertional hypoxemia, a conditional recommendation is made for ambulatory oxygen use.
  • For patients who are mobile outside of home and require more than 3 L/min of continuous-flow oxygen during exertion (very-low-quality evidence), a conditional recommendation for ambulatory liquid-oxygen is made.
  • Patients and their caregivers are educated on oxygen equipment and safety, as per the best-practice statement.


“These guidelines provide the basis for evidence-based use of home oxygen therapy in adults with COPD or ILD but also highlight the need for additional research to guide clinical practice,” the panel concluded.

—Leigh Precopio


Jacobs SS, Krishnan JA, Lederer DJ, et al; American Thoracic Society Assembly on Nursing. Home oxygen therapy for adults with chronic lung disease. an official American Thoracic Society clinical practice guideline. Am J Respir Crit. 2020;202(10):121-141. doi:10.1164/rccm.202009-3608ST