Randomized Trial of Nocturnal Oxygen in Chronic Obstructive Pulmonary Disease

Lacasse, Yves; Sériès, Frédéric; Corbeil, François; Baltzan, Marc; Paradis, Bruno; Simão, Paula; Fernández, Araceli Abad; Esteban, Cristóbal; Guimarães, Miguel; Bourbeau, Jean; Aaron, Shawn D.; Bernard, Sarah; Maltais, François

doi:10.1056/nejmoa2013219

Cited by 55 publications

(33 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At lowland, a study in COPD patients did not show a significant benefit after 2 years with NOT on PAP (control group 19.8 ± 5.6−20.5 ± 6.5 mmHg and NOT 18.3 ± 4.7 −19.5 ± 5.3 mmHg, p = 0.79). A recent trial was stopped prematurely because of recruitment and retention difficulties, showing—in this underpowered analysis—no clear positive or negative effect on survival or progression to long-term oxygen therapy in COPD patients ( Lacasse et al, 2020 ) and therefore emphasizing again the need of efficiently powered trials to study the long-term effect of NOT in patients with COPD. However, according to our previous publication from the current trial, NOT had a positive effect on various sleep measures, but not on daytime exercise capacity, blood gases, or cognitive performance compared with placebo at altitude ( Tan et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of Nocturnal Oxygen Therapy on Daytime Pulmonary Hemodynamics in Patients With Chronic Obstructive Pulmonary Disease Traveling to Altitude: A Randomized Controlled Trial

et al. 2021

View full text Add to dashboard Cite

IntroductionWe investigated whether nocturnal oxygen therapy (NOT) mitigates the increase of pulmonary artery pressure in patients during daytime with chronic obstructive pulmonary disease (COPD) traveling to altitude.MethodsPatients with COPD living below 800 m underwent examinations at 490 m and during two sojourns at 2,048 m (with a washout period of 2 weeks < 800 m between altitude sojourns). During nights at altitude, patients received either NOT (3 L/min) or placebo (ambient air 3 L/min) via nasal cannula according to a randomized crossover design. The main outcomes were the tricuspid regurgitation pressure gradient (TRPG) measured by echocardiography on the second day at altitude (under ambient air) and various other echocardiographic measures of the right and left heart function. Patients fulfilling predefined safety criteria were withdrawn from the study.ResultsTwenty-three COPD patients [70% Global Initiative for Chronic Obstructive Lung Disease (GOLD) II/30% GOLD III, mean ± SD age 66 ± 5 years, FEV1 54% ± 13% predicted] were included in the per-protocol analysis. TRPG significantly increased when patients traveled to altitude (from low altitude 21.7 ± 5.2 mmHg to 2,048 m placebo 27.4 ± 7.3 mmHg and 2,048 m NOT 27.8 ± 8.3 mmHg) difference between interventions (mean difference 0.4 mmHg, 95% CI −2.1 to 3.0, p = 0.736). The tricuspid annular plane systolic excursion was significantly higher after NOT vs. placebo [2.6 ± 0.6 vs. 2.3 ± 0.4 cm, mean difference (95% confidence interval) 0.3 (0.1 − 0.5) cm, p = 0.005]. During visits to 2,048 m until 24 h after descent, eight patients (26%) using placebo and one (4%) using NOT had to be withdrawn because of altitude-related adverse health effects (p < 0.001).ConclusionIn lowlanders with COPD remaining free of clinically relevant altitude-related adverse health effects, changes in daytime pulmonary hemodynamics during a stay at high altitude were trivial and not modified by NOT.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT02150590.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Nocturnal Oxygen Therapy on Daytime Pulmonary Hemodynamics in Patients With Chronic Obstructive Pulmonary Disease Traveling to Altitude: A Randomized Controlled Trial

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In the recent INOX trial, the application of nocturnal oxygen failed to reduce mortality or progression to long-term oxygen therapy in COPD patients with nocturnal hypoxemia. 96 However, the presence of sleeprelated hypoventilation in such patients cannot be excluded. Hence, the role of diagnosis and therapy of SRBD in COPD patients with borderline and nocturnal hypoxemia is another potential research area.…”

Section: Recent Trends and Future Directionsmentioning

confidence: 99%

A review of therapies for the overlap syndrome of obstructive sleep apnea and chronic obstructive pulmonary disease

Suri

2021

FASEB BioAdvances

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are common chronic diseases. These two noncommunicable diseases (NCDs) are prevalent among approximately 10% of the general population. Approximately 1% of the population is affected by the co-existence of both conditions, known as the overlap syndrome (OS). OS patients suffer from greater degrees of nocturnal oxygen desaturation and cardiovascular consequences than those with either condition in isolation.Besides OS, patients with COPD may suffer from a spectrum of sleep-related breathing disorders, including hypoventilation and central sleep apnea. The article provides an overview of the pathogenesis, associated risk factors, prevalence, and management of sleep-related breathing disorders in COPD. It examines respiratory changes during sleep caused by COPD and OSA. It elaborates upon the factors that link the two conditions together to lead to OS. It also discusses the clinical evaluation and diagnosis of these patients. Subsequently, it reviews the pathophysiological basis and the current evidence for three potential therapies: positive airway pressure therapy [including continuous positive airway pressure (CPAP) and bilevel positive airway pressure], oxygen therapy, and pharmacological therapy. It also proposes a phenotypic approach towards the diagnosis and treatment of OS and the entire spectrum of sleep-related breathing disorders in COPD. It concludes with the current evidence gaps and future areas of research in the management of OS.

show abstract

“…Auffällig in der Studienpopulation war, dass es keine Patienten mit einer reinen nächtlichen Sauerstofftherapie gab. Die Daten der kürzlich veröffentlichen INOX-Studie zeigten keinen Einfluss auf die Sterblichkeit der 243 eingeschlossenen COPD Patienten, allerdings wurde die Studie vorzeitig aufgrund von Rekrutierungsproblemen beendet und war statistisch für den Endpunkt nicht aussagekräftig [28].…”

Section: Conclusion Patients Referred To Lung Transplantation Useunclassified

Sauerstofftherapie bei Kandidaten zur Lungentransplantation − eine monozentrische retrospektive Analyse von 807 Patienten

2021

View full text Add to dashboard Cite

Zusammenfassung Fragestellung Die Sauerstofflangzeittherapie wird häufig bei Patienten mit fortgeschrittenen Lungenerkrankungen und respiratorischer Insuffizienz angewandt. Eine Behandlung mit Sauerstoff hat Einfluss auf die Organzuteilung auf der Warteliste zur Lungentransplantation und ist mit Sterblichkeit auf der Warteliste assoziiert. Die Studie untersuchte die Sauerstofftherapie bei Patienten zur Evaluation einer Lungentransplantation. Methode Eine retrospektive Untersuchung wurde in einem großen deutschen Transplantationszentrum zwischen September 2011 und Januar 2019 durchgeführt, Daten der Sauerstofftherapie wurden untersucht und die Indikation überprüft. Der Untersuchungszeitraum wurde in 2 Perioden vor und nach der Einführung von Empfehlungen zur Sauerstofftitration im 3. Quartal 2015 eingeteilt. Die Daten wurden zuerst univariat und dann multivariat mit dem Endpunkt „Aufnahme in die Warteliste“ analysiert. Ergebnisse 807 Patienten wurden in die Studie eingeschlossen, 396 in der ersten und 411 Patienten in der zweiten Periode. Von allen wurden 293 Patienten (36,3 %) im Beobachtungszeitraum transplantiert. 630 (78 %) der Patienten gaben eine Sauerstofftherapie von über 12 Stunden des Tages an. Nach Einführung der Sauerstofftitration konnte in Periode 2 bei 212 (57 %) von 372 Patienten die Indikation einer Sauerstofflangzeittherapie bei Erstvorstellung bestätigt werden. Der Sauerstofffluss bei Blutgasanalysen zur Kontrolle war in Periode 2 mit 0,5 l/min (25 und 75 %-Quartile 0,0 – 2,0) gegenüber 2 l/min (25 und 75 %-Quartile 0,5 – 3,0) deutlich niedriger. In einer multivariaten Analyse war als unabhängige Variable der Sauerstofffluss mit der Aufnahme auf die Warteliste assoziiert. Schlussfolgerung Kandidaten zur Lungentransplantation wenden häufig eine Sauerstofflangzeittherapie an. Die Indikation sollte kritisch überprüft werden. Die Indikation zur Sauerstofflangzeittherapie scheint mit der Wahrscheinlichkeit der Aufnahme auf die Warteliste zur Lungentransplantation assoziiert zu sein und könnte in Zukunft ein Selektionskriterium dafür darstellen.

show abstract

Randomized Trial of Nocturnal Oxygen in Chronic Obstructive Pulmonary Disease

Cited by 55 publications

References 26 publications

Effect of Nocturnal Oxygen Therapy on Daytime Pulmonary Hemodynamics in Patients With Chronic Obstructive Pulmonary Disease Traveling to Altitude: A Randomized Controlled Trial

Effect of Nocturnal Oxygen Therapy on Daytime Pulmonary Hemodynamics in Patients With Chronic Obstructive Pulmonary Disease Traveling to Altitude: A Randomized Controlled Trial

A review of therapies for the overlap syndrome of obstructive sleep apnea and chronic obstructive pulmonary disease

Sauerstofftherapie bei Kandidaten zur Lungentransplantation − eine monozentrische retrospektive Analyse von 807 Patienten

Contact Info

Product

Resources

About