Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Chronic obstructive pulmonary disease - Management
Basis for recommendation

When to admit

  • These recommendations are based on expert opinion in the National Institute for Health and Clinical Excellence (NICE) clinical guideline Management of chronic obstructive pulmonary disease in adults in primary and secondary care (partial update) [National Clinical Guideline Centre, 2010; NICE, 2010].

Hospital-at-home

  • These recommendations are based on the NICE chronic obstructive pulmonary disease (COPD) guideline [National Clinical Guideline Centre, 2010; NICE, 2010].
    • Evidence from four randomized controlled trials identified by NICE suggests that hospital-at-home schemes are safe and effective alternatives to inpatient care for people with acute exacerbations of COPD. However, NICE found insufficient data to make firm recommendations about which patients with an exacerbation are most suitable for hospital-at-home. The recommendation that hospital-at-home schemes may be suitable for people with few indications for hospital admission who prefer treatment at home is based on the expert opinion of the guideline development group.

Oxygen

  • These recommendations are mainly based on evidence from audits of emergency admissions and on expert opinion in the Guideline for emergency oxygen use in adult patients from the British Thoracic Society [British Thoracic Society, 2008]. NICE did not include recommendations made in 2004 in their updated 2010 guideline because of concerns that they were out of date; they now refer readers to local protocols.
    • The recommendation to change to a 24% Venturi mask at a flow rate of 2 L/min if the oxygen saturation decreases after commencing oxygen is based on expert opinion from CKS reviewers.

© NHS Institute for Innovation and Improvement