A review of long-term oxygen therapy for chronic obstructive pulmonary disease

Abstract

This study aimed to review the evidence for the use of long-term oxygen therapy for patients with chronic obstructive pulmonary disease (COPD). The design was a systematic Cochrane review of randomized controlled trials (RCTs) of long-term oxygen therapy for COPD and main outcome measure was survival on home oxygen therapy. Five RCTs were identified. Data from two trials of nocturnal oxygen therapy in mild to moderate hypoxaemia were aggregated. Data from the other three trials could not be aggregated because of differences in trial design and patient selection. Treatment with continuous versus nocturnal oxygen therapy produced a significant improvement in mortality after 24 months [Peto odds ratio 0.45, 95% confidence interval (95% CI) 0.25-0.81] for the continuous therapy group. Treatment with oxygen therapy versus no oxygen therapy showed a significant improvement in mortality after five years in the group receiving oxygen therapy (Peto odds ratio 0.42, 95% CI 0.18-0.98). There was no difference in mortality for patients with COPD and mild to moderate daytime hypoxaemia and nocturnal desaturation receiving nocturnal oxygen therapy versus no oxygen therapy or sham treatment. Long-term oxygen therapy versus no oxygen therapy in patients with COPD and moderate hypoxaemia had no effect on survival. In conclusion, long-term oxygen therapy improved survival in a selected group of COPD patients with severe hypoxaemia but few co-morbidities. Long-term oxygen therapy did not improve survival in patients with moderate hypoxaemia or in those with mild to moderate hypoxaemia and arterial desaturation at night.

Long-Term Oxygen Therapy in COPD: Factors Affecting and Ways of Improving Patient Compliance

“…In terms of maximum benefit, continuous oxygen administration (≥15 h/d) is superior to intermittent or nocturnal use [3]. There is also accumulating evidence that LTOT has favourable effects on other outcome measures, including depression, cognitive function, quality of life, exercise capability, and frequency of hospitalization [4–10]. Moreover, it stabilizes and sometimes reverses the progression of pulmonary arterial hypertension and it diminishes as well cardiac arrhythmias and electrocardiographic findings indicative of myocardial ischemia [11, 12].…”

A pilot study of the self-reported quality of life for patients with chronic obstructive pulmonary disease

“…[26][27][28][29][30] Patients with COPD experience a loss of social roles and become isolated and withdrawn. 30 Depression, a prevalent psychologic symptom reported by patients with COPD, has been identified as a stronger predictor of QOL than lung function (forced expiratory volume in 1 second [FEV 1 ]).…”

Combined Pulmonary Fibrosis and Emphysema, a clinical review

“…Following the guidelines that apply for the general population, patients with CPFE should be vaccinated against influenza viruses and Streptococcus pneumonia. Long term oxygen therapy is appropriate in case of hypoxemia by extrapolating current knowledge based on COPD patients [40]. The presence of emphysema per se does not necessarily mean the presence of an obstructive syndrome.…”