A crossover study of short burst oxygen therapy (SBOT) for the relief of exercise-induced breathlessness in severe COPD

Abstract

Background: Previous small studies suggested SBOT may be ineffective in relieving breathlessness after exercise in COPD.

Methods: 34 COPD patients with FEV1 <40% predicted and resting oxygen saturation ≥93% undertook an exercise step test 4 times. After exercise, patients were given 4 l/min of oxygen from a simple face mask, 4 l/min air from a face mask (single blind), air from a fan or no intervention.

Results: Average oxygen saturation fell from 95.0% to 91.3% after exercise. The mean time to subjective recovery was 3.3 minutes with no difference between treatments. The mean Borg breathlessness score was 1.5/10 at rest, rising to 5.1/10 at the end of exercise (No breathlessness = 0, worst possible breathlessness = 10). Oxygen therapy had no discernable effect on Borg scores even for 14 patients who desaturated below 90%. 15 patients had no preferred treatment, 7 preferred oxygen, 6 preferred the fan, 3 preferred air via a mask and 3 preferred room air.

Conclusions: This study provides no support for the idea that COPD patients who are not hypoxaemic at rest derive noticeable benefit from oxygen therapy after exercise. Use of air from a mask or from a fan had no apparent physiological or placebo effect.

Figure 1

Oxygen saturation before and after exercise. Left hand panel: All 34 patients. Right hand panel: 14 patients who desaturated below 90%

Figure 2

Borg breathlessness scores before and after exercise. Left hand panel: All 34 patients. Right hand panel: 14 patients who desaturated below 90%

Figure 3

Pulse rates before and after exercise. Left hand panel: All 34 patients. Right hand panel: 14 patients who desaturated below 90%