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Hi Molly,   Your brother's doctor is the best one to answer this question as he/she will know more about your brother's total health condition, but at 35%, your brother is probably in Stage 3, or severe COPD. Most patients at this stage need to be on supplemental oxygen 24/7.   Hope this helps you understand, but never be afraid to call the doctor's office and ask questions. That's your right!   Best, Kathi
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