88% or 90%? Lowest ok oxygen saturation without using supplementary O2?

[O2Trees]

Hi everyone,

Ive noticed more recently that 90% seems to be the cut-off level below which we are prescribed or advised to use supplemental oxygen. As far as I remember it used to be 88% - Im talking five years and more ago. So Im wondering if the advice has changed.

Some years back, I asked Molly Jackson, the respiratory nurse who started our Breathe Easy group and went on to be the BLF's respiratory nurse advisor in Breathing Space (not sure if that mag is still going). Anyway a pukka person to know about this stuff. I asked her if it would matter if I desaturated just to 87% and my levels came back up quickly, would I be ok without using my ambulatory oxygen and she said yes.

I do use ambulatory oxygen for walking any distance at a brisk (for me!) speed, so Im thinking of e.g. when Im just going round the supermarket, strolling round our small town or on the beach. Not continuous walking at speed.

Just wanting to know if advice has changed as 88% was what I was always told in the past but my oxygen nurse now says below 90% use your oxygen.

Thanks for any thoughts or comments. Hope everyone is as well as possible

[sassy59]

Good to see you Jean. I have no idea as Pete isn’t on any oxygen but I just wanted to say hello. I hope you get some answers and you and Rita are keeping well. 🤗💖

[O2Trees in reply to sassy59]

Hello to you Carole, always here and always so loving and supportive. Im glad Pete doesnt need oxygen, he has enough to deal with. We are fine - I have been finding my O2 levels slightly lower compared with readings for same activities prior to having a non-infective flare-up in March. Which seems odd since with seriously hospitalisations in 2018 the previous O2 levels reasserted themselves fairly quickly. Lots of nice replies though which are reassuring. Lots of love to you and Pete xxx

[sassy59 in reply to O2Trees]

Thank you for your kind words Jean. Pleased you’ve had some good replies and lots of love to you and Rita too. Xxxx

[Snackjack]

Hello, sorry I do not have the answer but would be very interested to know the answer as I have to keep a check on my levels. Best wishes and take care. xx

[skischool]

To the best of my knowledge Jean ,keeping sats within the 88-92% range is still considered the safe level for patients in hospital with a known Copd diagnosis on or off supplementary oxygen and always seems to be the mantra delivered by attending physicians?

Love Ski's and Scruff's

🙃😻 xx

[Ern007 in reply to skischool]

I agree - I have had sats at 88% without intervention with oxigen.

[Annie31 in reply to skischool]

Me too Ski's!

[BreatheasyBe in reply to skischool]

88-92% is my baseline sitting. Consultant happy with no oxygen at this rate. Any lower and my ambulatory oxygen is used ie walking.

[O2Trees in reply to BreatheasyBe]

Interesting - the 88-92 thing still prevails, so Im unsure why my nurse has said below 90% needs supplemental O2.

[Maricopa in reply to O2Trees]

I’m a serious c02 retainer. No oxygen yet. But for a few yrs I desat to 76 easily. Like during a shower. Tonight my lowest for a minute or so was 70%. I’m still alive and kicken. My pulmonologist has said with severe copd they don’t worry much unless below 87%. I think due to Covid and only telephone visits I’m probably slipping through the cracks. My sats do rise to 91-93 within a minute or so.

[O2Trees in reply to skischool]

That is what I have always thought Mike so I was surprised and alarmed when Becky (O2 nurse) said below 90%. I know I'll get to needing more supplementary O2 in time but for now I enjoy strolling on the beach etc and just using the cylinders for exertion as you say below. xx

[skischool in reply to O2Trees]

I think there has been some confusion amongst the nursing profession recently because of Covid when some folk were rushed into hospital because their Sats where 90% or lower? X

[O2Trees in reply to skischool]

Good point - this was the first time i had heard her say that x

[judg69]

When I was prescribed 24/7 oxygen 4 years ago , the defining parameter was 88 or below, either at rest or anytime during a 3 minute walk test. I am in the U.S.. Other countries may have somewhat different parameters, Best Wishes, judg69

[O2Trees in reply to judg69]

We have a six minute walk test here in the UK and Ive always understood it to be as you are saying here.

[skischool]

Might be worth considering reading this Jean,if you have chronic Copd and your sats are normaly within the range of 88-92% then that would be considered a safe level but probably worthy of further investigation with a view to being considered for Ltot or supplementary oxygen on exertion.gponline.com/pulse-oximetry...

xx

[O2Trees in reply to skischool]

You've probably seen in your reply above that I do use supplementary!

[Tissy1]

Hi , my wife's advice is still 88 - 92.The respiratory nurse calls about every 6 weeks & my wifes care matron about the same ,or as requested, there has never been any conversation about it altering.

Take care.

Carpe diem.

[Aingeful]

My levels are always 88-92. Oxygen has never been suggested for me.

[Maricopa in reply to Aingeful]

Mine are too during rest. So that’s why I’ve not been prescribed oxygen. But now they drop pretty low when I exert. I have found that it takes quite a lot of low saturation incidents before one drops to the floor. Lol. I seriously have been riding in the 70’s for at least 3 yrs upon exertion. They quickly rise back to an acceptable level.

[Kristicats]

Long-term administration of oxygen (usually at least 15 hours daily) improves survival in COPD patients with more severe hypoxaemia. The need for oxygen should be assessed in COPD patients with an FEV1 less than 30% predicted (consider assessment if FEV1 is 30-49%), cyanosis, polycythaemia, peripheral oedema, raised JVP, and when oxygen saturation levels are 92% or less breathing air.

Assessment for long-term oxygen therapy requires measurement of arterial blood gas tensions. Measurements should be taken on 2 occasions at least 3 weeks apart to demonstrate clinical stability.

From current BNF Re Long term oxygen therapy

[O2Trees in reply to Kristicats]

Thanks Christi!

[tomc]

O2Trees, are you OK I upset you unintentionally and not seen you since, I m so sorry for upsetting you It was completely unintentional.

[O2Trees]

Heavens no Tom! Tbh I dont remember what that was about so it certainly hasnt stayed with me. Im hardly around at present as my sister has had a massive stroke on top of already being on palliative care for S.4 cancer. I have been taken up with that in all its complexities and have little emotional energy left over for any other communication.

Im sorry if you have been worrying about this and thank you for checking it out. I hope you are keeping as well as possible. Best, jean

[skischool in reply to O2Trees]

Sorry to eavesdrop on that depressing news Jean and my thoughts are with your sister and you,knowing of the consequences of stroke i can imagine how difficult things will be for you both at this time.With love Mikeski's and the Scruffy one x

[Hidden in reply to O2Trees]

I’m sure many of us have been thinking about you, Jean, so I’m glad you’ve come on here to reassure Tom. Really sorry about your sister, that must be incredibly stressful for you all. I hope she’s getting good care but tbh that seems increasingly rare these days 😘😘😘

[Hidden in reply to O2Trees]

Ps don’t even THINK of replying, you’ve got far too much going on x

[O2Trees in reply to Hidden]

Thank you so much Hanne and Mike - Mary was already on palliative care for the cancer, having refused all treatment - she's 91 and has lived a fantastic life. She has actually had excellent care at the stroke unit at the Royal Free Hospital but is unable to speak or swallow. I have had to fight to be able to visit and have been allowed three visits so far. But despite being worked with for nearly a month, Mary has made no significant progress and none is now anticipated. So this coming week she is being moved to the North London Hospice at which point her feeding tube will be removed and things will take their course.

My daughter Megan is flying back from New York on Wednesday which will be fourteen days after her second Pfizer jab so she won't have to quarantine. She is very close to Mary and until the stroke had been talking to her on Whatsapp every other day and sending her photos. Im just crossing fingers nothing happens before Meg is back and able to visit.

Ive been checking in here every few days to see what's happening, just no energy or the will to post or reply at the moment but always wishing friends here the best possible health. xx