Source: Annual Congress 2008 - Lung and bone marrow transplantation: miscellaneous
Disease area: Airway diseases

Abstract

Background: There is survival benefit from O₂ therapy for severely hypoxemic COPD patients (PaO₂≤55 mmHg). Does O₂ have a role for patients with intractable dyspnea at the end of life, but with PaO₂>55 mmHg? Research Objectives: To evaluate O₂ vs. medical air for relief of dyspnoea in these people. Methods: This double-blind RCT recruited patients from 9 sites in the USA, UK and Australia. Participants received O₂ or medical air via nasal cannulae from a concentrator at 2 liters/minute, at least 15 hours/day for 7 days. Outcomes included breathlessness (0-10 numerical rating scale (NRS) measured twice daily) and McGill Quality of Life. Longitudinal repeated measures mixed models with unstructured covariance matrices assessed time, intervention, and their interaction. Significant responders were individuals with >1 point NRS improvement; predictors of response were explored. Results: Participants (n=239) were: mean age, 73 (SD 10); 62% male; 64% COPD; mean PaO₂, 77 (SD 12). Neither gas was superior in relieving dyspnea (p=0.456) or improving QOL (p=0.281). Dyspnea and QOL improved over the 7-day study period in both arms (p<0.0001 for both). Significant predictors of morning response were: O₂ arm (OR 1.86, p=0.0344) and high baseline breathlessness (OR 0.20, p=0.0003). Responders were more likely to want to continue treatment (51% vs 39%; p=0.0753). Conclusions: Although palliative O₂ conferred no benefit over medical air, people with more severe breathlessness may derive benefit from O₂. Use of palliative O₂ for the symptomatic management of dyspnea in non- or mildly-hypoxemic patients is not supported by this adequately-powered randomized trial, however selected patients may benefit.

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A. Fardmousavi, K. Najafizadeh, M. Marashian, A. Rostami, N. Yamani (Tehran, Isfahan/Isfahan, Islamic Republic Of Iran). Quality of life in lung transplantation candidates and its relationship with psychosocial disorders. Eur Respir J 2008; 32: Suppl. 52, 1634

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