Is the long-term use of supplemental oxygen beneficial for people with COPD?

Chronic obstructive pulmonary disease (COPD) affects millions of Americans and is the third leading cause of death in the U.S. COPD is not a single disease, but rather a group of diseases that make it difficult to breathe. This includes diseases such as emphysema, chronic bronchitis, and occasionally, asthma. COPD can be caused by a variety of factors, but the biggest factor in its development is tobacco smoke1. Symptoms of COPD worsen over time and include wheezing, shortness of breath, chest tightness, and coughing with profuse mucus2.

COPD can also result in a lowered level of oxygen in the blood. In healthy humans, blood oxygen levels should be between 95-98%. When the blood oxygen level is lower than this, it is referred to as desaturation or hypoxemia. Severe desaturation can require medical intervention3. In addition to desaturation, other symptoms of COPD can be severe enough to result in hospitalization. While there is no cure for COPD, there are treatments that can manage and alleviate symptoms2.

One of these is long-term treatment with supplemental oxygen. However, a recent study shows this treatment may not help certain people with COPD4.

The study used 738 people with stable COPD and moderate desaturation (89-93%), either when resting or induced by exercise. One group of subjects was given no supplemental oxygen. The other group was prescribed either 24-hour supplemental oxygen, if they experienced desaturation at rest, or supplemental oxygen only during sleep and exercise, if the desaturation was exercise-induced4.

The investigators were primarily concerned with the effects that supplemental oxygen would have on time to death or time to first hospitalization. However, they also examined how supplemental oxygen might affect other aspects, such as anxiety, depression, quality of life, and sleep4.

The investigators found that subjects who used supplemental oxygen did not live longer or have a first hospitalization event later than subjects who did not use supplemental oxygen. In addition, they found no benefit in any other aspect that was measured, including qualify of life, anxiety, and depression4.

These results show that it is not effective to use supplemental oxygen for people with stable COPD and moderate desaturation. However, the use of supplemental oxygen could be beneficial for people with COPD and severe desaturation. This could be determined in future studies.

Future studies could also identify new treatments for COPD. Hopefully, these new treatments will have more effect on increased lifespan and improving symptoms than the supplemental use of oxygen.

 

This blog post is based off an original research article. You can read the original research article for free here.

Sources:

1: Chronic Obstructive Pulmonary Disease (COPD) [Internet]. 2016. Atlanta (GA): Centers for Disease Control and Prevention; [cited 2016 Oct 28]. Available from https://www.cdc.gov/copd/index.html

2: What is COPD? [Internet]. 2013. Bethesda (MD): National Heart, Lung, and Blood Institute; [cited 2016 Oct 28]. Available from http://www.nhlbi.nih.gov/health/health-topics/topics/copd

3: Hypoxemia (low blood oxygen) [Internet]. 2015. Mayo Clinic [cited 2016 Oct 28]. Available from http://www.mayoclinic.org/symptoms/hypoxemia/basics/definition/sym-20050930

4: Albert RK, Au DH, Blackford AL, Casaburi R, Cooper JA, Criner GJ, Diaz P, Fuhlbrigge AL, Gay SE, Kanner RE, et al. 2016. A randomized trial of long-term oxygen for COPD with moderate desaturation. N Eng J Med. 375(17):1617-27.

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