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Meta-Analysis
. 2005 Oct 19;2005(4):CD001744.
doi: 10.1002/14651858.CD001744.pub2.

Domiciliary oxygen for chronic obstructive pulmonary disease

J M Cranston  1 , A J Crockett, J R Moss, J H Alpers
Affiliations
Meta-Analysis

Domiciliary oxygen for chronic obstructive pulmonary disease

J M Cranston et al. Cochrane Database Syst Rev. .

Abstract

Background: Domiciliary oxygen therapy has become one of the major forms of treatment for hypoxaemic chronic obstructive pulmonary disease (COPD) patients.

Objectives: To determine the effect of domiciliary oxygen therapy on survival and quality of life in patients with COPD.

Search strategy: Randomised controlled trials (RCTs) were identified using the Cochrane Airways Group COPD register using the search terms: home OR domiciliary AND oxygen. Searches were current as of January 2005.

Selection criteria: Any RCT in patients with hypoxaemia and COPD that compared long term domiciliary or home oxygen therapy with a control treatment.

Data collection and analysis: Data extraction was performed independently by two reviewers.

Main results: Six randomised controlled trials were identified. Survival data was aggregated from two trials of the treatment of nocturnal oxygen therapy in patients with mild to moderate COPD and arterial desaturation at night. Survival data was also aggregated from two trials of continuous oxygen therapy versus no oxygen therapy in mild to moderate COPD. Data could not be aggregated for the other two trials because of differences in trial design and patient selection. Nott 1980: continuous oxygen therapy versus nocturnal oxygen therapy: there was a significant improvement in mortality after 24 months (Peto odds ratio 0.45, 95% confidence interval 0.25 to 0.81). MRC 1981: domiciliary oxygen therapy versus no oxygen therapy: there was a significant improvement over five years in mortality in the group receiving oxygen therapy (Peto odds ratio 0.42, 95% confidence interval 0.18 to 0.98). In the two studies of nocturnal oxygen versus no oxygen therapy in patients with COPD and arterial desaturation at night: there was no difference in mortality between treated and non treated groups for either trial or when the trials were aggregated. In the two trials of long-term oxygen therapy versus no oxygen therapy in COPD patients with mild to moderate hypoxaemia: there was no effect on survival for up to three years of follow up.

Authors' conclusions: Long-term home oxygen therapy improved survival in a selected group of COPD patients with severe hypoxaemia (arterial PaO2 less than 55 mm Hg (8.0 kPa)). Home oxygen therapy did not appear to improve survival in patients with mild to moderate hypoxaemia or in those with only arterial desaturation at night.

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Conflict of interest statement

None known.

Figures

1
1
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Chaouat 1999 {published data only}
    1. Chaouat A, Weitzenblum E, Kessler R, Charpentier C, Enrhart M, Schott R, et al. A randomized trial of nocturnal oxygen therapy in chronic obstructive pulmonary disease patients. European Respiratory Journal 1999;14(5):1002‐1008. [MEDLINE: ] - PubMed
Fletcher 1992 {published data only}
    1. Fletcher EC, Luckett RA, Goodnight‐White SA, Miller CC, Qian W, Costarangos‐Galarza C. A double‐blind trial of nocturnal supplemental oxygen for sleep desaturation in patients with chronic obstructive pulmonary disease and a daytime PaO2 above 60 mm Hg. American Review of Respiratory Disease 1992;145(5):1070‐6. - PubMed
Gorecka 1997 {published data only}
    1. Gorecka D, Gorzelak K, Sliwinski P, Tobiasz M, Zielinsli J. Effect of long‐term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxaemia. Thorax 1997;52(8):674‐9. - PMC - PubMed
Haidl 2004 {published data only}
    1. Haidl P, Clement C, Wiese C, Dellweg D, Kohler D. Long‐term oxygen therapy stops the natural decline of endurance in COPD patients with reversible hypercapnia. Respiration 2004;71(4):342‐7. [MEDLINE: ] - PubMed
MRC 1981 {published data only}
    1. Report of the Medical Research Council Working Party. Long‐term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Lancet 1981;1:681‐5. - PubMed
NOTT 1980 {published data only}
    1. Grant I, Heaton RK, McSweeny AJ, Adams KM, Timms RM. Neuropsychologic findings in hypoxemic chronic ostructive pulmonary disease. Archives of Internal Medicine 1982;142(8):1470‐6. - PubMed
    1. Nocturnal Oxygen Therapy Trial Group. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Annals of Internal Medicine 1980;93(3):391‐8. - PubMed
    1. Timms RM, Khaja FU, Williams GW. Hemodynamic response to oxygen therapy in chronic obstructive pulmonary disease. Annals of Internal Medicine 1985;102(1):29‐36. [MEDLINE: ] - PubMed

References to studies excluded from this review

Grant 1982 {published data only}
    1. Grant I, Heaton RK, McSweeny AJ, Adams KM, Timms RM. Neuropsychologic findings in hypoxemic chronic obstructive pulmonary disease. Archives of Internal Medicine 1982;142(8):1470‐6. - PubMed

Additional references

Jadad 1996
    1. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled Clinical Trials 1996;17(1):1‐12. [MEDLINE: ] - PubMed