Recognize the indications for evaluation of exercise-induced arterial oxygen desaturation.

Explanation:

If one documented hypoxia during exercise then one can say that this could occur in the patient's home life. This is grounds for further treatment- In a COPD patient it calls for home oxygen if the acute attack is over and in an asthmatic it calls for further bronchodilation.

The cut off saturation is <88% whether during light exercise or during sleep. Aim for sats > 90%. For sleep empirically increase O2 by 1 liter/min (For now do not introduce PaO2 into the decision making because we do not routinely measure ABGs with this procedure).

Patients need re-evaluation after 1-3 months of maximal medical therapy.

Only 2 modalities have shown to improve survival in COPD patients- One is O2 if indicated and the other is lung transplant. Pulmonary rehab improves Quality of life but survival benefit is not known.