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Treatments for pulmonary fibrosis

Oxygen therapy

Understanding oxygen therapy

Understanding oxygen therapy

Breathing disorders such as pulmonary fibrosis can affect the movement of oxygen from the lungs into the blood. This means that the oxygen level in the blood may drop, and the body’s organs, tissues, and cells may not get the amount of oxygen they need. This can lead to you feeling tired and being less active.1,2

Oxygen therapy keeps the level of oxygen in your blood above a certain level, which reduces breathlessness. It can, therefore, help people with pulmonary fibrosis to stay more active throughout their day.

Only your treatment team can guide you on when oxygen may be needed and what type of oxygen delivery should be used. If you think you need oxygen or higher doses of your oxygen, speak to your treatment team who can talk to you about the options available.

Preparing for oxygen therapy

Oxygen therapy will change how you approach your day-to-day life. Getting around the house and going out may become more of a challenge.2 However, with some advice and preparation, the transition can be made easier.

At first, you may only need oxygen to do physical activities, such as gardening or taking a walk. However, depending on your overall health, oxygen therapy may be needed throughout the day, even when you are resting.

As oxygen is considered a medicine, it must be prescribed by a doctor. Based on a series of tests, the prescription will provide details about how much oxygen you need and how often you will need it.2

Your pulmonologist or respirologist, as part of your treatment team, will also discuss which type of oxygen and delivery system best suits you.

Preparing for oxygen therapy

Types of oxygen delivery2,3

Nose
Nasal cannula

Small plastic tubes, or prongs, that fit into both of your nostrils

Face Mask
Face mask

Fits over your nose and mouth and straps onto your head

Oxygen storage and transport2

Oxygen concentrator
Oxygen concentrator

A small machine that provides just oxygen by removing all other gasses from the air

Compressed gas
Compressed gas

Oxygen is stored under pressure in different sized tanks. Some tanks are small enough to carry around in a backpack

Liquid oxygen
Liquid oxygen

Oxygen which can be used in small tanks and refilled from large containers delivered to your home

The right choice for you depends on several things, including how much oxygen you need, when you need it, where you live, and your access to electricity.1,2,4

Although you may be prescribed extra oxygen over the long term,5 this doesn’t mean that you must limit your daily life. Often patients find that when a prescription of supplemental oxygen is made, it helps them to be more active.6

Oxygen at home requires safety measures7

Because oxygen is stored in pressurised containers, there are certain safety measures you will need to take when using oxygen at home.
Smoke detectors
Smoke detectors

Install smoke detectors in every room

Extinguishers
Extinguishers

Keep fire extinguishers in an accessible place

Safe storage
Safe storage

Store the oxygen tank in a clean, dry place—at least 2 m (6 ft) away from any heat, electricity, or fire

No smoking
No smoking

Do not smoke near the oxygen tank

Further guidance on using oxygen

Expand all

Always follow all instructions and guidelines supplied with your oxygen, as well as local laws and regulations.


Below are some further precautions to take:
  • Post a sign in the room where you have your oxygen that there is to be “no smoking”
  • Tell your local fire department that there is oxygen in the house
  • Make sure you have a working smoke alarm inside or directly outside the room where oxygen is being used
  • Keep a fire extinguisher close to your oxygen tank and make sure you and/or your carer know how to use it
  • Store your oxygen system in a well-ventilated area, such as in an open room, rather than in a closet or cupboard
  • Remember to always turn off your oxygen when you’re not using it to avoid releasing any oxygen into a room or enclosed space. If the oxygen is turned on, don’t put the nasal cannula or mask on the bed or a chair, even for a few minutes
  • Use 100% cotton bed linens and blankets, as they are less likely to give off sparks from static electricity
  • Try to keep at least 3 m (10 ft) away from open flames, such as a fireplace, gas heater or stove, candles, etc
  • Pay close attention to the gauges on your oxygen equipment to make sure they are not running low. If you are running low, tell your oxygen supplier so that they can deliver refills
  • Make a note of any questions you have about your oxygen delivery system. Stick them to your oxygen tank or in a place where you will see them. Be sure to ask your treatment team and/or oxygen delivery person any questions you may have the next time you see them

Always follow all instructions and guidelines supplied with your oxygen, as well as local laws and regulations. Below are some further precautions to take.

Avoid certain products and devices while using oxygen, for example:
  • Petroleum-based lubricants like Vaseline, Chapstick, or Blistex on chapped lips or nostrils
  • Electrical appliances such as hair dryers, curling irons, heating pads, and electric razors
  • Flammable liquids, such as cleaning fluid, paint thinner, and aerosols (eg, hair spray or deodorant)
  • Alcohol-based hand sanitisers
  • Oil-based products, such as vapour rubs, oil-based hand lotions, and petroleum jelly


Never cut your oxygen tubing and never use more than a 15-m (50-foot) long tubing. Don’t store your oxygen in enclosed spaces, such as in the boot of a car.

Safety precautions to take when using oxygen cylinders
  • Store the cylinder in an upright position, using a cart, or strapped into place so that it will not fall over
  • Keep your cylinder in a place where it is not likely to get knocked over
  • Monitor your oxygen levels and plan ahead to ensure you don’t run short; always have backup tanks available

Safety precautions when using liquid oxygen
  • Don’t turn the tank on its side, as this may cause the liquid oxygen to leak out
  • Keep the tank at least 1.5-m (5-foot) away from electric or gas heaters, steam pipes, furnaces, and radiators

Safety precautions when using oxygen concentrators
  • Never use an extension cord to plug in your concentrator
  • Don’t cover the unit and always keep it at least 15-cm (6-inches) away from the wall, curtains, or anything else that might block the filter or prevent air circulation around it. This will prevent the unit overheating
  • Consider buying a backup generator in the event of power outage

Travelling with oxygen therapy

If you are on oxygen therapy and you would like to travel, it is important to plan ahead. Depending on how you are travelling, you may need to make certain arrangements. For example, there may be forms to fill in, additional charges (eg, from airlines), or special procedures for the storage and transport of your oxygen equipment.2

The following steps will help you prepare for travelling2:
One
Speak to your treatment team

about your plans, so they can discuss your ability to travel

Two
Check with your travel provider

to guarantee that they can accommodate all your treatments, especially supplemental oxygen therapy

Three
Contact a travel insurance provider to

ensure you have an insurance policy in place to cover all eventualities, such as medical expenses, cancellations, and personal equipment/belongings

Four
Download our checklists

for air, train, and car travel to help guide you through your travel planning process

Alert icon
Important

Many people still manage to do lots of travelling, even if they receive oxygen therapy. If you are involved in a support group, ask others in the group if they have travelled while using oxygen therapy to share hints and tips.

Altitude and elevation

Altitude and elevation

You may find it harder to breathe at high altitudes due to the low oxygen levels in the air. If you are travelling to high altitudes, you may require supplemental oxygen. If you are already on oxygen therapy, you may need to increase your oxygen flow.8

Depending on the severity of your condition, your treatment team may do pre-travel checks to determine whether you need oxygen therapy at your destination.8 If you have any plans to travel, make sure you inform your treatment team, so they can make sure you have all the treatments you need and have taken all the precautions needed to protect your health.

Flying with supplementary oxygen

When an aircraft is flying, the oxygen level is lower than at ground level. If you need oxygen therapy at ground level, you will also need oxygen in-flight, and may need to increase the flow during the flight.9

Even if you are not currently on oxygen therapy, it’s a good idea to have your treatment team assess whether you will need in-flight oxygen if you are planning to fly.

If your treatment team recommends in-flight oxygen, there are a few tasks you need to do before your flight. Some of these tasks may need to be done months in advance and even before booking airline tickets. For example, you will need to contact the airline and complete forms to ensure that you are ready to travel. You will also need to check the airline’s requirements for in-flight oxygen. You must talk to your insurance provider about oxygen while travelling as you may need or benefit from additional insurance.2

Flying with supplementary oxygen

Each airline has their own specific rules and policies regarding in-flight oxygen supply. The European Lung Foundation has a nicely organised ‘airline index’  which lists all major airlines and their oxygen policies, as well as contact information.

Fit-to-fly assessments

Fit-to-fly assessments

If you have an underlying medical condition, some airlines require you to provide a statement from your treatment team proving you are ‘fit-to-fly’. In addition to the information in your medical record and your shared travel plans, your treatment team may perform a number of different assessments before issuing a letter to the airline.

One simple test you may need to perform is called a walking test. In this test, you’ll be asked to walk 50 m (55 y) or climb one flight of stairs. If you’re unable to complete the task due to breathlessness or any other respiratory symptoms, the treatment team will probably recommend the use of in-flight oxygen.9

There are also several other tests that your treatment team may use to assess your fitness to travel.

Today, even travelling long distances with extra oxygen is possible with proper planning. Learn more about travelling with pulmonary fibrosis and find some helpful information in our Travelling with pulmonary fibrosis section.

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Abbreviations: ILD, interstitial lung disease; IPF, idiopathic pulmonary fibrosis; PF, pulmonary fibrosis; RA-ILD, rheumatoid arthritis-associated interstitial lung disease.

  1. Swigris JJ, Stewart AL, Gould MK, Wilson SR. Patients' perspectives on how idiopathic pulmonary fibrosis affects the quality of their lives. Health Qual Life Outcomes. 2005;3:61.

  2. American Thoracic Society. Patient education: oxygen therapy. Accessed October 2, 2024. https://www.thoracic.org/patients/patient-resources/resources/oxygen-therapy.pdf

  3. American Lung Association. Oxygen delivery devices and accessories. Updated June 7, 2024. Accessed October 2, 2024. https://www.lung.org/lung-health-diseases/lung-procedures-and-tests/oxygen-therapy/oxygen-delivery-devices

  4. Plantier L, Cazes A, Dinh-Xuan AT, Bancal C, Marchand-Adam S, Crestani B. Physiology of the lung in idiopathic pulmonary fibrosis. Eur Respir Rev. 2018;27(147):170062.

  5. Raghu G, Collard HR, Egan JJ, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183(6):788-824.

  6. Egan JJ. Follow-up and nonpharmacological management of the idiopathic pulmonary fibrosis patient. Eur Respir Rev. 2011;20(120):114-117.

  7. COPD.net. The do’s and don’ts of using supplemental oxygen at home. January 20, 2017. Accessed October 2, 2024. https://copd.net/living/dos-donts-supplemental-oxygen

  8. Luks AM. Do lung disease patients need supplemental oxygen at high altitude? High Alt Med Biol. 2009;10(4):321-327.

  9. Shand D. The assessment of fitness to travel. Occup Med (Lond). 2000;50(8):566-571.