Emphysema is a chronic lung condition that causes shortness of breath. As emphysema progresses, the air sacs in the lungs are damaged, making it harder to breathe. Some people with severe emphysema may need supplemental oxygen to help them breathe easier.
What is emphysema?
Emphysema is a type of chronic obstructive pulmonary disease (COPD) that damages the air sacs (alveoli) in the lungs. Healthy alveoli are elastic and balloon-like, expanding when you inhale to take in oxygen and deflating when you exhale to expel carbon dioxide. In emphysema, the alveoli lose their elasticity and are unable to fully expand and contract. This makes breathing difficult.
As emphysema progresses, more and more alveoli are destroyed. The damaged alveoli also merge together, forming large air spaces instead of many small ones. This reduces the surface area available for gas exchange in the lungs. As a result, less oxygen gets into the bloodstream and more carbon dioxide builds up in the body.
What causes emphysema?
The main cause of emphysema is long-term exposure to tobacco smoke, either from smoking cigarettes or from secondhand smoke. The chemicals in tobacco smoke damage the alveoli and stimulate excess production of mucus in the lungs. Other risk factors include:
- Exposure to industrial pollutants or dust
- Alpha-1 antitrypsin deficiency, a genetic disorder
- Repeated respiratory infections
Emphysema symptoms
Common signs and symptoms of emphysema include:
- Shortness of breath, especially with activity
- Wheezing or coughing, sometimes producing mucus
- Feeling like you can’t breathe deeply enough
- Fatigue
- Unintended weight loss
As the condition worsens, people with emphysema may develop a barrel-chested appearance and have trouble doing simple activities due to shortness of breath.
When is oxygen needed for emphysema?
Many people with advanced emphysema eventually need extra oxygen to help them breathe comfortably. Your doctor may prescribe supplemental oxygen if:
- You have shortness of breath even when resting
- You have oxygen saturation levels below 88-92% consistently
- Your symptoms are not relieved enough with medications
Measuring oxygen levels
A simple blood test called pulse oximetry can measure the oxygen saturation level in your blood. This test involves clipping a small device called an oximeter onto your finger. The oximeter uses light waves to determine how much oxygen is circulating in your bloodstream.
Normal oxygen saturation levels range from 95-100%. As emphysema progresses, oxygen levels often drop below 88-92%, indicating the need for supplemental oxygen. Your doctor may periodically check your oxygen saturation to determine if and when you need oxygen therapy.
When to use oxygen
If prescribed, you should use supplemental oxygen:
- During sleep: Overnight oxygen helps prevent drops in oxygen levels that can strain the heart.
- During exercise or activity: Oxygen while active helps relieve shortness of breath.
- When flying: Decreased air pressure in an airplane cabin tends to lower oxygen saturation.
- As needed for shortness of breath: Portable oxygen systems allow you to use oxygen whenever symptoms flare up.
Some people only need oxygen at certain times, while others require it 24/7. Your doctor will advise you on when to use oxygen based on your individual needs and oxygen levels.
Oxygen therapy options
There are several types of supplemental oxygen systems available:
- Stationary oxygen concentrators: Electrical devices that extract oxygen from room air. They are used at home and plug into an outlet.
- Portable oxygen concentrators: Smaller battery-powered versions that provide mobility outside the home.
- Compressed oxygen tanks: Contain pressurized oxygen gas. They are compact but heavy.
- Liquid oxygen systems: Oxygen is stored as a cold liquid and converted to gas as needed. These systems allow greater mobility.
Your doctor will help determine the best oxygen setup based on your needs, insurance coverage, and lifestyle.
Tips for living with oxygen therapy
Using supplemental oxygen takes some adjustment. Here are some tips to help you live comfortably with oxygen therapy:
- Use oxygen as prescribed. Wear your cannula or mask during all recommended times.
- Stay active if possible. Oxygen while exercising can help you stay independent.
- Consider portable oxygen for travel and activities outside the home.
- Get in the habit of checking your oxygen tank levels frequently.
- Prevent tripping hazards by safely routing oxygen tubing when moving around.
- Stay hydrated and use a humidifier to prevent dry nasal passages.
- No smoking or open flames. Oxygen is flammable.
- Let family and friends help with tank deliveries and schedule refills in advance.
With proper use of oxygen therapy, many people with emphysema can breathe easier, remain active, and enjoy an improved quality of life.
Conclusion
People with advanced emphysema often need supplemental oxygen due to low oxygen levels in the bloodstream. Oxygen may be needed during sleep, activities, flying, or all the time. Pulse oximetry testing helps determine if and when oxygen is required. Various oxygen delivery systems are available, including concentrators and compressed gas tanks. With proper oxygen therapy, emphysema symptoms can be better managed.