Oxygen therapy helps people with emphysema breathe more easily. In the later stages of the illness, oxygen may also extend someone’s life.

Emphysema is a type of chronic obstructive pulmonary disease (COPD). It tends to worsen over time, although people can still live long lives with the disease.

People with emphysema have damage to their alveoli, which are the sacs in the lungs that hold oxygen and exchange gases. The condition is more common in current and former smokers.

Oxygen is an explosive gas, so people who use oxygen in their homes must not light fires or smoke near the oxygen tank. A doctor can help a person decide whether to use oxygen and weigh the risks and benefits.

Keep reading to learn more about how oxygen therapy can benefit people with emphysema and the types available.

A tank of oxygen sitting in the corner of a hospital room, to be used for emphysema.Share on Pinterest
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Some, but not all, people with emphysema need oxygen.

People may not need oxygen therapy in the early stages of COPD. In the later stages of the disease, the alveoli develop more damage and become less able to exchange oxygen and carbon dioxide.

This results in hypoxemia. Doctors may recommend oxygen therapy to help a person maintain a blood oxygen saturation of 90% or more.

Oxygen therapy can be intermittent or continuous. Intermittent therapy may help people whose oxygen levels only drop in certain situations, such as during exercise. Doctors recommend continuous therapy for those whose resting oxygen saturation falls below 88%.

The main benefit of oxygen therapy for emphysema is that it can prolong someone’s life. An older study states that people with emphysema who have low blood oxygen levels will live longer with oxygen therapy.

Oxygen may also help reduce other symptoms of emphysema, such as:

However, by the time a person needs oxygen, the disease has already advanced significantly. This means their life expectancy may be fairly short.

A 2018 population-based cohort study in Sweden found that 12–31% of people on long-term oxygen therapy died after 1 year. At 2 years, this increased to 22–62% of people, and by 5 years, it was 36–81%.

A doctor may recommend that a person begin using oxygen therapy when their blood oxygen saturation falls below 88% or their blood oxygen level falls below 55 millimeters of mercury (mmHg) at rest.

If this only happens after exercise, a doctor may suggest intermittent therapy, in which a person uses oxygen for shorter periods. However, if oxygen saturation falls below 88% in other situations as well, a person may require continuous oxygen therapy. This means a person has to use oxygen for 15 hours per day or more.

At home, a person has several options for oxygen therapy, including:

  • Oxygen concentrator: These devices take air from the surrounding area and concentrate it into oxygen. They do not require an oxygen tank, making them safer and less likely to combust. They come in stationary forms for use at home and ambulatory machines, which a person can take with them.
  • Compressed oxygen: This form uses an oxygen tank to deliver oxygen. Most compressed oxygen tanks are ambulatory tanks, which means a person can take them wherever they go. The tanks can be heavy and can explode if exposed to high heat or around flames.
  • Oxygen-conserving device: A person can purchase an oxygen-conserving device to use with compressed oxygen. This prevents the tank from releasing oxygen when a person is not inhaling, which may prevent a person from taking in too much oxygen and reduce the risks associated with oxygen use.

Oxygen concentrators require a constant source of electricity, but traditional oxygen tanks do not.

In a hospital, a person might receive oxygen through a small tube placed in their nose. Rarely, a person might also need to use a ventilator. This is a machine that breathes for someone.

The general aim of oxygen therapy is to keep oxygen levels in the blood above 90%. However, getting too much oxygen is harmful.

A 2017 paper emphasizes that the overuse of oxygen during an acute COPD exacerbation may worsen symptoms of COPD and could worsen hypercapnia, or high carbon dioxide levels in the blood.

A 2018 review of studies examining oxygen therapy in hospitalized adults during acute COPD exacerbation also found that people may do worse when they get too much oxygen. Experts recommend keeping oxygen saturation between 88–92% for people experiencing acute COPD exacerbation.

For those using oxygen therapy at home, experts recommend aiming for 90–92% oxygen saturation to avoid side effects.

A person should speak with their doctor about their personal targets and ensure they know how to use their equipment safely.

The main risk of oxygen therapy is that oxygen is an explosive gas. The presence of lit candles, cigarettes, or fire near an oxygen tank can start a fire or cause an explosion. A person should never smoke while using oxygen or in the same room as an oxygen machine or tank.

Some other potential risks of oxygen therapy include:

  • dry nose or throat, which may cause coughing or nosebleeds
  • headaches
  • complications such as hypercapnia
  • oxygen toxicity

The symptoms of oxygen toxicity are varied but may include sudden:

  • chest pain
  • severe coughing
  • shortness of breath
  • dizziness or disorientation
  • headaches
  • anxiety
  • sight or hearing changes
  • seizures

This list is not comprehensive. If someone suddenly develops new or worsened symptoms after using oxygen, they should seek emergency medical attention.

Some things a person may want to think about or ask their doctor before starting oxygen therapy include:

  • Do I currently need oxygen?
  • Will it help prolong my life?
  • Should I use oxygen most of the time or only as needed?
  • Which type of machine is safest for my needs?
  • How much oxygen should I aim to use? What are the limits?
  • Are any other treatments likely to help with symptoms?
  • How much will oxygen therapy cost?

In some cases, people with end stage emphysema prefer to focus on comfort measures rather than oxygen therapy. People who feel this way may want to ask their doctor what their life expectancy might be if they do not use oxygen.

Oxygen therapy can help a person with emphysema live longer. It may also improve quality of life, especially when emphysema symptoms interfere with daily activities, cause anxiety and stress, or get worse when a person enjoys their hobbies or exercises.

Oxygen therapy is not right for everyone, though. Depending on someone’s preferences and needs, they may require different types of oxygen therapy equipment. They may also need to make adjustments to avoid the risks of a fire, such as stopping smoking.

People can discuss the potential benefits and risks of oxygen therapy for emphysema with a doctor.