Short-burst oxygen therapy for COPD patients: A 6-month randomised, controlled study

Department of Medicine, University of Auckland, Окленд, Auckland, New Zealand
European Respiratory Journal (Impact Factor: 7.64). 05/2006; 27(4):697-704. DOI: 10.1183/09031936.06.00098805
Source: PubMed


Short-burst oxygen therapy (SBOT) remains widely advocated for patients with chronic obstructive pulmonary disease (COPD), despite a lack of supporting evidence. The aim of this randomised, double-blind, placebo-controlled, parallel group study was to determine whether SBOT improves health-related quality of life (HRQL) or reduces acute healthcare utilisation in patients discharged following an acute exacerbation of COPD. Consecutive patients were screened; 78 of 331 were eligible for randomisation to cylinder oxygen, cylinder air or usual care following discharge. Patients were elderly with high acute healthcare utilisation, forced expiratory volume in one second of <1 L and had dyspnoea limiting daily activity but were not hypoxaemic at rest. Over the 6-month study period, there were no significant differences between patient groups in HRQL (Chronic Respiratory Questionnaire (CRQ), 36-item Short-Form Health Survey, Hospital Anxiety and Depression Scale) except for CRQ emotion domain. There were no significant differences in acute healthcare utilisation. Time to readmission was greatest in the usual care group. Cylinder use was high initially, but rapidly fell to very low levels within weeks in both cylinder oxygen and air groups. In conclusion, the availability of short-burst oxygen therapy for chronic obstructive pulmonary disease patients discharged from hospital following an acute exacerbation did not improve health-related quality of life or reduce acute healthcare utilisation. These results provide no support for the widespread use of short-burst oxygen therapy.

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Available from: John Kolbe, Apr 04, 2014
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    • "Previous short-term studies of SBOT for patients with COPD involved small numbers of patients and most of the trials failed to demonstrate any benefit from the use of SBOT either before or after exercise [10-19]. In one long-term study [20], patients who were randomized to "SBOT" using either oxygen or a placebo cylinder (air) over a six month period had high initial use of both types of cylinder and very low use subsequently and there was no difference between the use of oxygen or air cylinders. Two systematic reviews have concluded that the published studies do not support the use of SBOT for patients with COPD [8,21]. "
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    ABSTRACT: Previous small studies suggested SBOT may be ineffective in relieving breathlessness after exercise in COPD. 34 COPD patients with FEV1 <40% predicted and resting oxygen saturation ≥93% undertook an exercise step test 4 times. After exercise, patients were given 4 l/min of oxygen from a simple face mask, 4 l/min air from a face mask (single blind), air from a fan or no intervention. Average oxygen saturation fell from 95.0% to 91.3% after exercise. The mean time to subjective recovery was 3.3 minutes with no difference between treatments. The mean Borg breathlessness score was 1.5/10 at rest, rising to 5.1/10 at the end of exercise (No breathlessness = 0, worst possible breathlessness = 10). Oxygen therapy had no discernable effect on Borg scores even for 14 patients who desaturated below 90%. 15 patients had no preferred treatment, 7 preferred oxygen, 6 preferred the fan, 3 preferred air via a mask and 3 preferred room air. This study provides no support for the idea that COPD patients who are not hypoxaemic at rest derive noticeable benefit from oxygen therapy after exercise. Use of air from a mask or from a fan had no apparent physiological or placebo effect.
    BMC Pulmonary Medicine 05/2011; 11(1):23. DOI:10.1186/1471-2466-11-23 · 2.40 Impact Factor
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    • "McDonald et al (1995) recruited patients who desaturated less on exercise and supplied heavier oxygen cylinders; they found no improvement in quality of life. In a more recent study, Eaton et al (2006) randomized 78 patients discharged after an acute exacerbation to cylinder oxygen, cylinder air or usual care. There were no significant differences between the groups in quality of life, breathlessness or acute healthcare utilization. "
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD) is an incurable, progressive illness that is the fourth commonest cause of death worldwide. Death tends to occur after a prolonged functional decline associated with uncontrolled symptoms, emotional distress and social isolation. There is increasing evidence that the end of life needs of those with advanced COPD are not being met by existing services. Many barriers hinder the provision of good end of life care in COPD, including the inherent difficulties in determining prognosis. This review provides an evidence-based approach to overcoming these barriers, summarising current evidence and highlighting areas for future research. Topics include end of life needs, symptom control, advance care planning, and service development to improve the quality of end of life care.
    International Journal of COPD 02/2008; 3(1):11-29. · 3.14 Impact Factor
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