Ambulatory oxygen for improving exercise capacity in patients with COPD
Evidence SummariesLevel of Evidence = D
Ambulatory domiciliary oxygen therapy might possibly have no effect on exercise capacity in patients with COPD, but may relieve dyspnoea post exercise and improve quality of life as regards dyspnoea and fatigue.
A Cochrane review 1 included 4 studies with a total of 331 subjects. In the intervention groups, the patients were on long-term (> 2 weeks) ambulatory domiciliary oxygen therapy. In the control groups the patients were given placebo air cylinders. Two studies showed a statistically and clinically significant benefit in favour of the intervention for dyspnoea post exercise. The quality of life domain for all four included studies produced a statistically significant benefit for the subcategories of dyspnoea and fatigue, in favour of the oxygen group (dyspnoea mean difference [MD] 0.28, 95% CI 0.10 to 0.45; fatigue MD 0.17, 95% CI 0.04 to 0.31). No evidence of any effect was reported for survival, and limited benefits were observed for exercise capacity as measured by step test and distance walk test.
Comment: The quality of evidence is downgraded by sparse data, indirectness of evidence, and potential reporting bias.
1. Ameer F, Carson KV, Usmani ZA et al. Ambulatory oxygen for people with chronic obstructive pulmonary disease who are not hypoxaemic at rest. Cochrane Database Syst Rev 2014;(6):CD000238. [PMID:24957353]
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