CF McDonald, CM Blyth, MD Lazarus, I Marschner and CE Barter
Department of Respiratory Medicine, Heidelberg Hospital, Australia.

It is unclear whether short-term benefits from supplemental oxygen translate into improved quality of life in patients with severe COPD. In a 12 wk double-blind randomized crossover study, we assessed the effects of supplemental air and oxygen on exercise performance (step tests and 6 min walking distance [6MWD]) initially and after two 6 wk periods at home using exertional cylinder air or oxygen. We measured quality of life at baseline and after the two 6 wk domiciliary periods. The 26 patients (24 males) had a mean age of 73 +/- 6 yr; mean FEV1, 0.9 +/- 0.4 L; mean DLCO, 10.6 +/- 2.4 ml/min/mm Hg; mean resting PO2, 69 +/- 8.5 (range 58 to 82) mm Hg; mean PCO2, 41 +/- 3.3 mm Hg; and mean resting SaO2, 94 +/- 2.1 (mean +/- SD). Laboratory tests were performed breathing intranasal air or oxygen at 4 L/min, and measurements were made of SaO2 and Borg dysnea scores. Supplemental oxygen increased 6MWD and steps by small, statistically significant increments acutely at baseline and after 6 and 12 wk, without corresponding falls in Borg score. Degree of desaturation at baseline did not correlate with increase in 6MWD or steps achieved at baseline or at 6 or 12 wk, nor with the domiciliary gas used. There was no difference in 6MWD or steps achieved while breathing supplemental oxygen after 6 wk of domiciliary oxygen compared with domiciliary air. Small improvements in quality of life indices were found after domiciliary oxygen, and mastery also improved after domiciliary air. There were no differences in quality of life, however, when domiciliary oxygen was compared with domiciliary air. Although oxygen supplementation induced small acute increments in laboratory exercise performance, such improvements had little impact on the patients' daily lives.

This article has been cited by other articles:

				E. M. Clini and N. Ambrosino Nonpharmacological treatment and relief of symptoms in COPD Eur. Respir. J., July 1, 2008; 32(1): 218 - 228. [Abstract] [Full Text] [PDF]

				W. MacNee Update in Chronic Obstructive Pulmonary Disease 2007 Am. J. Respir. Crit. Care Med., April 15, 2008; 177(8): 820 - 829. [Full Text] [PDF]

				A. Qaseem, V. Snow, P. Shekelle, K. Sherif, T. J. Wilt, S. Weinberger, D. K. Owens, and for the Clinical Efficacy Assessment Subcommittee Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline from the American College of Physicians Ann Intern Med, November 6, 2007; 147(9): 633 - 638. [Abstract] [Full Text] [PDF]

				T. J. Wilt, D. Niewoehner, R. MacDonald, and R. L. Kane Management of Stable Chronic Obstructive Pulmonary Disease: A Systematic Review for a Clinical Practice Guideline Ann Intern Med, November 6, 2007; 147(9): 639 - 653. [Abstract] [Full Text] [PDF]

				M. L. Nonoyama, D. Brooks, G. H. Guyatt, and R. S. Goldstein Effect of Oxygen on Health Quality of Life in Patients with Chronic Obstructive Pulmonary Disease with Transient Exertional Hypoxemia Am. J. Respir. Crit. Care Med., August 15, 2007; 176(4): 343 - 349. [Abstract] [Full Text] [PDF]

				S J Quantrill, R White, A Crawford, J S Barry, S Batra, P Whyte, and C M Roberts Short burst oxygen therapy after activities of daily living in the home in chronic obstructive pulmonary disease Thorax, August 1, 2007; 62(8): 702 - 705. [Abstract] [Full Text] [PDF]

				J. M. Bradley, T. Lasserson, S. Elborn, J. MacMahon, and B. O'Neill A Systematic Review of Randomized Controlled Trials Examining the Short-term Benefit of Ambulatory Oxygen in COPD Chest, January 1, 2007; 131(1): 278 - 285. [Abstract] [Full Text] [PDF]

				L. Nici, C. Donner, E. Wouters, R. Zuwallack, N. Ambrosino, J. Bourbeau, M. Carone, B. Celli, M. Engelen, B. Fahy, et al. American thoracic society/european respiratory society statement on pulmonary rehabilitation. Am. J. Respir. Crit. Care Med., June 15, 2006; 173(12): 1390 - 1413. [Full Text] [PDF]

				Statement on Home Care for Patients with Respiratory Disorders Am. J. Respir. Crit. Care Med., June 15, 2005; 171(12): 1443 - 1464. [Full Text] [PDF]

				Y. Lacasse, R. Lecours, C. Pelletier, R. Begin, and F. Maltais Randomised trial of ambulatory oxygen in oxygen-dependent COPD Eur. Respir. J., June 1, 2005; 25(6): 1032 - 1038. [Abstract] [Full Text] [PDF]

				T. J Ringbaek and P. Lange Outdoor activity and performance status as predictors of survival in hypoxaemic chronic obstructive pulmonary disease (COPD) Clinical Rehabilitation, March 1, 2005; 19(3): 331 - 338. [Abstract] [PDF]

				N. Ambrosino and S. Strambi New strategies to improve exercise tolerance in chronic obstructive pulmonary disease Eur. Respir. J., August 1, 2004; 24(2): 313 - 322. [Abstract] [Full Text] [PDF]

				N Ambrosino, D Giannini, and I D'Amico How good is the evidence for ambulatory oxygen in chronic obstructive pulmonary disease Chronic Respiratory Disease, July 1, 2004; 1(3): 125 - 126. [PDF]

				J P Fuldl and M M Cotton Performance enhancement in chronic obstructive pulmonary disease Chronic Respiratory Disease, April 1, 2004; 1(2): 95 - 98. [Abstract] [PDF]

				E. Bruera, C. Sweeney, J. Willey, J L. Palmer, F. Strasser, R. C Morice, and K. Pisters A randomized controlled trial of supplemental oxygen versus air in cancer patients with dyspnea Palliative Medicine, December 1, 2003; 17(8): 659 - 663. [Abstract] [PDF]

				D. D. Sin, F. A. McAlister, S. F. P. Man, and N. R. Anthonisen Contemporary Management of Chronic Obstructive Pulmonary Disease: Scientific Review JAMA, November 5, 2003; 290(17): 2301 - 2312. [Abstract] [Full Text] [PDF]

				M. Emtner, J. Porszasz, M. Burns, A. Somfay, and R. Casaburi Benefits of Supplemental Oxygen in Exercise Training in Nonhypoxemic Chronic Obstructive Pulmonary Disease Patients Am. J. Respir. Crit. Care Med., November 1, 2003; 168(9): 1034 - 1042. [Abstract] [Full Text] [PDF]

				American Thoracic Society/European Respiratory Society Statement: Standards for the Diagnosis and Management of Individuals with Alpha-1 Antitrypsin Deficiency Am. J. Respir. Crit. Care Med., October 1, 2003; 168(7): 818 - 900. [Full Text] [PDF]

				J.R. Curtis and D.L. Patrick The assessment of health status among patients with COPD Eur. Respir. J., June 1, 2003; 21(41_suppl): 36S - 45s. [Abstract] [Full Text] [PDF]

				G. L. Snider Enhancement of Exercise Performance in COPD Patients by Hyperoxia: A Call for Research Chest, November 1, 2002; 122(5): 1830 - 1836. [Abstract] [Full Text] [PDF]

				T. Eaton, J.E. Garrett, P. Young, W. Fergusson, J. Kolbe, S. Rudkin, and K. Whyte Ambulatory oxygen improves quality of life of COPD patients: a randomised controlled study Eur. Respir. J., August 1, 2002; 20(2): 306 - 312. [Abstract] [Full Text] [PDF]

				K. Fujimoto, Y. Matsuzawa, S. Yamaguchi, T. Koizumi, and K. Kubo Benefits of Oxygen on Exercise Performance and Pulmonary Hemodynamics in Patients With COPD With Mild Hypoxemia* Chest, August 1, 2002; 122(2): 457 - 463. [Abstract] [Full Text] [PDF]

				A. Gershon, C. K. N. Chan, and G. Guyatt Home Oxygen Requalification Chest, July 1, 2001; 120(1): 318 - 319. [Full Text] [PDF]

				G. H. GUYATT, D. A. McKIM, B. WEAVER, P. A. AUSTIN, R. E. J. BRYAN, S. D. WALTER, M. L. NONOYAMA, I. M. FERREIRA, and R. S. GOLDSTEIN Development and Testing of Formal Protocols for Oxygen Prescribing Am. J. Respir. Crit. Care Med., March 15, 2001; 163(4): 942 - 946. [Abstract] [Full Text]

				G. H. Guyatt, D. A. McKim, P. Austin, R. Bryan, J. Norgren, B. Weaver, and R. S. Goldstein Appropriateness of Domiciliary Oxygen Delivery Chest, November 1, 2000; 118(5): 1303 - 1308. [Abstract] [Full Text] [PDF]

				R Garrod, E A Paul, and J A Wedzicha Supplemental oxygen during pulmonary rehabilitation in patients with COPD with exercise hypoxaemia Thorax, July 1, 2000; 55(7): 539 - 543. [Abstract] [Full Text]