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Study challenges value of oxygen therapy in end-of-life care
Date:9/2/2010

DURHAM, N.C. Millions of patients with advanced disease in palliative care settings receive oxygen therapy to help them breathe more easily. But a new study from Duke University Medical Center says roughly half of them don't benefit from the intervention, and among those who do benefit, it doesn't make a bit of difference whether they get pure oxygen or just plain old room air both offer equal benefit.

"Offering oxygen when patients begin experiencing shortness of breath has become standard care in many places, but the practice is not based on rigorous scientific investigation," says Dr. Amy Abernethy, an oncologist and palliative care expert in the Duke Comprehensive Cancer Center and the lead author of the study appearing in the Sept. 3 issue of The Lancet. "We needed to do a study like this one to find out if what has become customary is actually meaningful and appropriate."

Abernethy says shortness of breath (also known as dyspnea) is a common symptom in very advanced stages of many diseases and disorders. Researchers say the problem is reported in 65 percent, 70 percent and 90 percent of patients nearing the end of life suffering from heart failure, lung cancer and chronic obstructive pulmonary disease, respectively. Shortness of breath is distressing for patients and their families as well, making normal activities like walking, talking, and socializing difficult. "So it is important to address it," says Abernethy.

The question becomes when and how. Clinical guidelines recommend oxygen when blood oxygen levels fall so low that a patient becomes hypoxic when there isn't enough oxygen in the blood to keep vital functions going. But there are large numbers of patients whose oxygen levels haven't fallen into the danger zone but who experience difficulty breathing and feel they need help. "In situations like these, physicians tend to use palliative oxygen treatment out of compassion," says Abernethy. "The decision is not
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Contact: Michelle Gailiun
michelle.gailiun@duke.edu
919-660-1306
Duke University Medical Center
Source:Eurekalert

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