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| The first 150 words of the full text of this article appear below. |
Many patients with severe chronic obstructive pulmonary disease
(COPD) develop hypoxaemia at rest when awake as their disease progresses. This may or may not be accompanied by hypercapnia but is a
poor prognostic feature, independent of the forced expiratory volume in
one second (FEV1).1 For many years the
scientific study of COPD was driven by the need to gain a greater
understanding of the processes which led to these disorders of gas
exchange. Ultimately this led to the introduction of effective
treatment designed to increase the arterial oxygen tension beyond
8.0 kPa for at least 15 hours per day. The well known randomised
controlled trials which confirmed the survival benefit of this
treatment2 3 are also the cornerstone of evidence based
oxygen prescribing.4 Since these results were published in
the 1980s the costs of oxygen therapy have increased steadily in the UK
and elsewhere5 and constitute one of the largest medical
expenses,
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