Supplemental oxygen vs medical air: which is more effective in COPD with exercise-induced desaturation?

  • Alison JA & al.
  • Eur Respir J
  • 1 May 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with chronic obstructive pulmonary disorder (COPD) and exercise-induced oxygen desaturation, both supplemental oxygen and medical air significantly improved exercise capacity and health-related quality of life (HRQoL) with no greater benefit from training with supplemental oxygen vs medical air.

Why this matters

  • Exercise-induced oxygen desaturation is common among people with COPD referred to pulmonary rehabilitation
  • Previous randomised trials comparing oxygen and air during exercise training had small sample sizes and included those on long-term oxygen therapy (LTOT) and non-desaturators. Hence stronger evidence is required to support or refute the use of supplemental oxygen.

Study design

  • 97 patients with moderate to severe COPD (oxygen desaturation
  • Primary outcomes: endurance exercise capacity (endurance shuttle walk test [ESWT] time and HRQoL (Chronic Respiratory Disease Questionnaire [CRQ]-total score).
  • Funding: National Health and Medical Research Council Australia.

Key results

  • Between-group analysis:
    • At the end of the 8-week training, no differences observed in ESWT time (mean difference [MD], 15 (95% CI, −106 to 136 seconds) and CRQ-total score (MD, 0.0 [95% CI, −0.3 to 0.3] points) between the oxygen and medical air groups.
    • At 6-month follow-up, both the groups did not differ in ESWT time (MD, −15 [95% CI, −148 to 118] seconds) and CRQ-total score (MD, −0.0 [95% CI, −0.4 to 0.3] points).
  • Within-group analysis:
    • At the end of the 8-week training, oxygen and medical air groups had significant improvement in ESWT (MD, 162 [95% CI, 80-244] and MD, 147 [95% CI, 59-235] seconds, respectively) and CRQ-total (MD, 0.4 [95% CI, 0.2-0.7] points for both group).
    • At 6-month follow-up, both the groups had improvement in ESTW time (MD, 76 [95% CI, −16 to 169] and MD, 91 [95% CI, −4 to 187] seconds, respectively) and CRQ-total score (MD, 0.3 [95% CI, −0.1 to 0.5] and MD, 0.4 [95% CI, 0.1 to 0.6] points, respectively).

Limitations

  • Acute response to oxygen supplementation was not evaluated.
  • Results cannot be generalised to patients with severe oxygen desaturation or other lung diseases.

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