Navigation Links
Ambulatory oxygen rarely a benefit in COPD patients without resting hypoxemia
Date:8/15/2007

Prescribing ambulatory oxygen in patients with chronic obstructive pulmonary disease (COPD) improves exercise performance, but not the quality of their daily life unless they have resting hypoxemia, according to researchers in Toronto.

Ambulatory oxygen therapy is routinely prescribed for those who do not meet criteria for mortality reduction, wrote Roger S. Goldstein, M.B., Ch.B., Professor of Medicine and Physical Therapy at West Park Healthcare Centre in Toronto, lead author of the study. [This study] suggests serious problems with the indiscriminate use of oxygen to relieve day-to-day dyspnea in patients with COPD without resting hypoxemia.

The study, which indicates that generalized treatment of COPD patients with ambulatory oxygen may be an unnecessary and inconvenient, and possibly even detrimental expense, appeared in the second issue for August of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

For many patients, a diagnosis of COPD comes with a prescription for ambulatory oxygen, even when they do not meet the standard criteria for long-term oxygen treatment (LTOT). In 2002, Medicare paid $2.2 billion for home oxygen therapy.

The researchers conducted a series of double-blind N-of-1 trials wherein 27 COPD patients without resting hypoxemia underwent three pairs of two-week trials, using either oxygen or compressed air (as a placebo). At the end of each trial period, patients were assessed with the Chronic Respiratory Questionnaire (CRQ) and St. Georges Respiratory Questionnaire (SGRQ), and given a timed walk test to assess their exercise performance. Neither the patients nor the assessors were aware of whether they had received oxygen or placebo during the trials.

As a group, the patients on oxygen showed improvement in the number of steps taken in the walk test, but no improvement in their dyspnea scores or on their questionnaires. When assessed as individuals who served as their own controls, four patients showed improvement in the dyspnea scores with oxygen, and only one was identified as a clear responder, whose overall scores and walk tests improved markedly on oxygen, and who requested early termination of the placebo phase of the trial during all three periods.

Although ambulatory oxygen acutely improved constant power endurance and a standardized home walking test, very few patients experienced benefit from oxygen at home, wrote the researchers.

These results are consistent with those in previous studies, which have likewise found that improvements in exercise capacity and endurance do not translate into perceived benefits in dyspnea and quality of life. However, one investigation in patients who had completed a pulmonary rehabilitation program, did find differences in the CRQ, suggesting a benefit from oxygen to more active patients.

These findings raise important questions about identifying patients who stand to benefit from oxygen. One approach to the issue is to restrict oxygen use to patients who show benefit from an N-of-1 trial, the researchers suggest, noting that while the costs of such trials are not negligible, they are considerably less than the cost of providing long-term ambulatory oxygen for patients who do not benefit from it.

The study also challenges us to learn what supplemental oxygen therapy can accomplish when coupled with an exercise program designed to potentiate oxygens effects, wrote M. Bradley Drummond, M.D., and Robert A. Wise, M.D., of Johns Hopkins University School of Medicine, in an accompanying editorial. Continued efforts with innovative approaches...will allow the treatment of COPD to move away from the limited data of the past into a future where COPD no longer damages and shortens the lives of so many.


'/>"/>

Contact: Suzy Martin
smartin@thoracic.org
212-315-8631
American Thoracic Society
Source:Eurekalert

Related medicine news :

1. The advantages of oxygen therapy
2. Oxygen Treatment may be injurious
3. Oxygen helps heal wounds
4. Oxygen Usage During Exercise Could Indicate Heart Problems
5. Oxygen Consumption During Workouts Could Indicate Heart Problems
6. Cooling Can Reduce The Risk Of Brain Damage In Oxygen Deprived Newborns
7. Air travel reduces oxygen level in the blood
8. Influence Of Heart Rate On Myocardial Oxygen Tension
9. Mobilizing Stem Cells at the Injured Site Using Hyperbaric Oxygen Treatments.
10. Stem cells mobilized by hyperbaric oxygen
11. New Sensor To Monitor Oxygen Deprivation In Babies During Birth
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/24/2017)... ... February 24, 2017 , ... Congratulations to Head Over Heels’ ... February 12th. Ms. Esparza qualified into this prestigious status after winning the ... Las Vegas, Nevada. Frida is one of approximately 25 gymnasts in the nation ...
(Date:2/23/2017)... ... 2017 , ... The 89th Academy Awards will be celebrated this weekend, which ... Center Bunkum Award. We invite you to enjoy our 11th annual tongue-in-cheek “salute” to ... the Center for American Progress (CAP), for its report, Lessons From State Performance on ...
(Date:2/23/2017)... ... February 23, 2017 , ... Los Angeles-based weight loss surgeon Michael ... “Mama June: From Not to Hot,” which will begin airing on February 24, 2017. ... to millions from the 2012 reality television series, “Here Comes Honey Boo Boo.” The ...
(Date:2/23/2017)... (PRWEB) , ... February 23, 2017 , ... ... Development will host a diverse symposium on “Doping in Sport: How ... and Sheppard Mullin Richter & Hampton LLP. The symposium will be held at ...
(Date:2/23/2017)... Phoenix (PRWEB) , ... February 23, 2017 , ... ... in Phoenix, announced today that it will soon begin franchising throughout the U.S. ... the mission to help bring the practice of meditation mainstream. Current Meditation will ...
Breaking Medicine News(10 mins):
(Date:2/24/2017)... Md. , Feb. 23, 2017 ... marketing of the PhenoTest BC Kit, performed on ... to identify organisms that cause bloodstream infections and ... likely to respond to (antibiotic sensitivity). The test ... to provide this important information, which can guide ...
(Date:2/24/2017)... 24 février 2017 ITL Limited, ( ASX : ITD ), ... ravie d,annoncer les excellents résultats semestriels clos le 31 ... Une présentation complète « Résultats et mise à jour sur ... . Faits marquants ... 1,04 million $ ; en hausse de 104 %) ...
(Date:2/24/2017)... 23, 2017 Non-alcoholic steatohepataitis (NASH) ... various drugs being developed for the treatment ... drugs that are in various phases of ... focuses on novel pharmacologic drugs & regenerative ... therapies, recombinant proteins and RNA-based therapeutics, but ...
Breaking Medicine Technology: