Low-dose oxygen therapy in COPD patients: are there any radiation-like risks?

PURPOSE OF REVIEW: Low-dose oxygen (LDO) supplementation is used by millions of COPD patients worldwide. The therapeutic benefits of LDO supplementation are well known. There are also several concerns regarding the potential for cellular harm from LDO in COPD patients. This review summarizes the current arguments and evidence pertaining to this important topic.

RECENT FINDINGS: LDO therapy has been used in COPD patients for more than 50 years. Over the years, data from randomized controlled trials has confirmed that LDO provides survival benefit in COPD patients with severe hypoxemia. Recent data, however, show that LDO does not provide any morality benefit for patients with a less severe degree of hypoxemia. There are several theoretical concerns regarding use of LDO in COPD patients, including radiation-like cellular risks because of oxygen toxicity. However, none of these have been validated in human clinical trials and remain somewhat peripheral to the clinician deciding whether or not to initiate LDO in a hypoxemic COPD patient.

SUMMARY: There is high-quality evidence that LDO is both well tolerated and highly efficacious for patients with COPD. There are several theoretical concerns regarding damage from oxygen free radicals from LDO in COPD patients. However, none of these have been validated or confirmed in human clinical trial data. Thus, the benefits of LDO clearly outweigh the risks from any theoretical concerns about oxygen toxicity.