Acute oxygen therapy does not improve cognitive and driving performance in hypoxaemic COPD

Cognitive and neuropsychological function may be adversely affected by low blood oxygen levels and this has been previously demonstrated in hypoxaemic COPD. The aim of this study was to assess whether supplemental oxygen therapy while driving a motor vehicle is justified in hypoxaemic COPD. We therefore used computer-based driving simulation to investigate whether acute intranasal oxygen therapy improves the cognitive and driving performance of such patients.

Thirty hypoxaemic COPD subjects with a current driving licence performed a 20-min computer-based driving simulation task and a 10-min psychomotor vigilance task (PVT) at baseline, and while breathing intranasal oxygen or intranasal air in a randomized, double-blind, cross-over protocol.

The mean (SD) age of the subjects was 72 years (8) and their mean driving experience was 50 years (10). Mean FEV(1) was 41% (18) of predicted and PaO(2) was 50.5 mm Hg (4.7) on air and 70.7 mm Hg (9.1) on oxygen. There were no statistically significant differences in any measure of driving performance or in reaction time measurements while breathing oxygen compared with air.

Acute oxygen therapy does not improve simulated driving performance or neurocognitive function as assessed by PVT in patients with hypoxaemic COPD. These data do not support the recommendation that oxygen should be used by this patient group while driving.