Ambulatory oxygen improves quality of life of COPD patients: a randomised controlled study

Abstract

It is unknown whether acute response to ambulatory oxygen (O 2 ) predicts longer term improvement in health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) patients.The aims of this study were 1) to assess the short-term clinical impact, as determined by HRQL, of ambulatory O 2 in a 12-week, double-blind, randomised crossover study of O 2 (versus cylinder compressed air) of dyspnoeic but not chronically hypoxic COPD patients with exertional desaturation ¡88% (n=41), and 2) to determine whether either baseline characteristics or acute response to O 2 predicts short-term (12 weeks) response. Primary outcome measures were Chronic Respiratory Questionnaire (CRQ), Hospital Anxiety and Depression scale and the short form (SF)-36.Improvements were seen in all domains of the CRQ for cylinder O 2 compared with cylinder air. Significant improvements were also noted in anxiety and depression and in certain domains of the SF-36. There were 28 (68%) acute responders to cylinder O 2 (defined as increase in 6-min walk o54 m or decrease in post-Borg dyspnoea o1) and 23 (56%) short-term responders (defined as clinically significant improvement in CRQ). However, acute and short-term responses were not correlated with no predictors of short-term response identified. At study completion, 14 (41%) of acute or short-term responders did not want to continue therapy, with 11 citing poor acceptability or tolerability.Short-term ambulatory oxygen is associated with significant improvements in healthrelated quality of life. These benefits cannot be predicted by baseline characteristics or acute response. Despite acute or short-term response, a substantial proportion of patients declined ambulatory oxygen.

Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis

“…Patient preference was also discussed in two out of four studies. This is known to be important as the COPD literature has demonstrated that even patients shown to get benefited from oxygen do not always wish to receive it (Eaton et al, 2002;Currow et al, 2007). It is also a critical issue given the subjective nature of dyspnoea and the fact that patients often have difficulty in describing the sensation (ATS, 1999).…”

Time to Desaturation Less Than One Minute Predicts the Need for Long-Term Home Oxygen Therapy

“…17 By contrast, Eaton et al, who studied patients with COPD and exercise desaturation, found improved quality of life in their patients. 18 Fujimoto et al, who studied 75 patients with mild to severe COPD and mild hypoxemia, found that their desaturator patients walked farther in the 6-min walk test and had improved pulmonary pressure after administration of oxygen during exercise. 19 Jolly et al found that their patients, especially the desaturators, walked farther and suffered less dyspnea after oxygen administration.…”

Are Oxygen-Conserving Devices Effective for Correcting Exercise Hypoxemia?

“…Third, our assessment was carried out at a single time point, using a 6MWT, so our results do not necessarily reflect the acceptance and effectiveness of this treatment in patients' daily lives. 31 Longer-term studies are needed to determine the impact on quality of life of the various oxygen-conserving devices.…”