Short burst oxygen therapy after activities of daily living in the home in chronic obstructive pulmonary disease

Abstract

Background: Short burst oxygen therapy (SBOT) is widely prescribed in the UK with little evidence of benefit. A study was performed to examine whether SBOT benefits patients when undertaking normal activities at home among those who already use it. Methods: Twenty-two patients with chronic obstructive pulmonary disease (COPD) were included in the study. All regularly used SBOT at home and claimed that it helps them. Each patient chose two daily living activities for which they used SBOT for relief of breathlessness. Patients were then randomised to use either an air or oxygen gas cylinder. At least 15 min later the same activity was performed using the other gas cylinder. The same process was then repeated for the second chosen activity. The main endpoints were subjective and objective times to recovery, analysed for each activity separately or taking the average over the two activities. A paired statistical analysis was performed. Results: All patients used SBOT with nasal prongs after exercise. Using the average recovery time over two activities for each patient, the mean objective recovery time was 38 s lower (95% CI 281 to +5) using oxygen and the mean subjective recovery time was 34 s lower (95% CI 269 to +2). Five patients were correctly able to distinguish oxygen from air after both activities and there was a suggestion that their recovery times were shorter than those who did not correctly identify the gases (91 s vs 20 s using objective recovery times, and 80 s vs 22 s using subjective recovery times), although this was a subgroup analysis based on only five patients with non-significant results. Conclusions: There is some evidence that SBOT shortens recovery time after activities of daily living in a selected group of patients with COPD, but the effect is small. There appears to be a subgroup of patients who may benefit to a much greater degree.

British Thoracic Society guidelines for home oxygen use in adults: accredited by NICE

“…Two studies examined oxygen delivery before and after exercise, while four studies administered oxygen after exercise. One study that examined the benefit of oxygen after exercise included patients given LTOT,111 however hypoxaemic and non-hypoxaemic patients were not analysed separately. There were no studies that specifically examined the benefits of SBOT ordered for hypoxaemic patients alone.…”

“…Patients were asked to choose whether they received treatment before or after exercise in a study that examined 22 stable COPD patients with moderate to severe disease 111. Subjects were studied at home undertaking an activity of choice (mean resting SaO 2 93.1% (range 82–98%)).…”

Update in Chronic Obstructive Pulmonary Disease 2007

“…It may shorten recovery time after activities of daily living in a selected group of patients with COPD but the effect is rather small (139). However, there may be a subgroup of patients who may benefit from this treatment (139).…”

A crossover study of short burst oxygen therapy (SBOT) for the relief of exercise-induced breathlessness in severe COPD

“…The pulse recovery time was shorter when oxygen was given but this did not seem to provide any symptomatic benefit. Quantrill [ 12 ] reported a small improvement of about 35 seconds in the subjective and objective recovery times when oxygen was given after exercise to patients with COPD who were already using SBOT at home and who reported benefit from it's use. However, these differences did not reach statistical significance and only 5 of 22 patients could correctly identify oxygen from air in Quantrill's single-blind study.…”