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Symptomatic oxygen for non-hypoxaemic chronic obstructive pulmonary disease
Hope Uronis1, Douglas C McCrory, Gregory Samsa
1Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Box 3841, Durham, NC, USA, 27710.
The Cochrane Database of Systematic Reviews
|June 17, 2011
Summary
Oxygen therapy can alleviate shortness of breath in chronic obstructive pulmonary disease (COPD) patients who are not severely hypoxemic. This finding offers relief for individuals not qualifying for standard long-term oxygen therapy (LTOT).
Area of Science:
- Pulmonary Medicine
- Respiratory Care
- Clinical Trials
Background:
- Dyspnoea is a primary symptom in chronic obstructive pulmonary disease (COPD).
- Long-term oxygen therapy (LTOT) is standard for hypoxemic COPD patients to improve survival and quality of life.
- The benefit of home oxygen for mildly or non-hypoxemic COPD patients lacking LTOT criteria remains unclear.
Purpose of the Study:
- To evaluate the efficacy of oxygen versus medical air in alleviating subjective dyspnoea for COPD patients not meeting LTOT criteria.
- Primary outcome: patient-reported dyspnoea.
- Secondary outcome: exercise tolerance.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched major databases (Cochrane, MEDLINE, EMBASE) up to November 2009.
- Included RCTs comparing oxygen vs. medical air in mildly/non-hypoxemic COPD patients.
Main Results:
- Twenty-eight trials involving 702 patients were identified; 18 trials (431 participants) were included in the meta-analysis.
- Oxygen significantly reduced dyspnoea (SMD -0.37, 95% CI -0.50 to -0.24, P < 0.00001).
- Significant heterogeneity was observed across studies.
Conclusions:
- Oxygen therapy provides symptomatic relief for dyspnoea in COPD patients who are mildly or non-hypoxemic and do not meet LTOT criteria.
- Due to significant heterogeneity, individual patient assessment is recommended.
- Further large-scale RCTs are needed to support these findings.
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