Short-burst oxygen therapy in chronic obstructive pulmonary disease

Despite widespread prescription, the efficacy of short-burst oxygen therapy has not been established.

To systematically review the available evidence for short-burst oxygen therapy in patients with chronic obstructive pulmonary disease (COPD).

Retrieval of randomized-controlled trials comparing short-burst oxygen (oxygen for breathlessness at rest, before exercise and after exercise) with placebo in patients with COPD. Data were extracted and, where possible, outcome measures were combined using RevMan analyses 4.2. The methodological quality of each trial was assessed using the PEDro scale.

Studies differed in the type of exercise test used, the amount of oxygen delivered and in the length of time for pre- or post-dosing. Quality of the included studies as rated by the PEDro scale was good. For many outcome measures, data could not be pooled for meta-analysis. Short-burst oxygen is primarily indicated for the symptomatic relief of breathlessness, and the bulk of evidence from this review suggests that short-burst oxygen therapy does not reduce breathlessness. For secondary outcome measures (exercise capacity, oxygen saturation [SaO(2)], other ventilatory parameters), the results are not consistent.

The studies in this review suggest that the widespread prescription of short-burst oxygen is not evidence-based. If prescription is to continue, the scientific rationale for short-burst oxygen therapy must be established.