COPD: oxygen helped relieve dyspnoea in severe cases.

Clinical bottom line (level 1b)

  1. Patients with severe respiratory disease who received oxygen compared with air had an improvement in oxygen saturation and felt less breathless.
  2. Patients felt that their breathing was improved (NNT = 3 at 10 minutes) .
Swinburn et al: American Review of Respiratory Disease 1991; 143: 913-915
Expires November 2003

The study

Double-blinded ?concealed randomised cross-over trial with intention-to-treat
Setting: university hospital, UK

22 patients (aged mean 58 years, 59% male) in hospital: 10 with interstitial lung disease, 12 with COPD who were severely disabled by respiratory distress (mean oxygen concentration 50 mmHg), and claimed benefit from supplemental oxygen.

Excluded if
  • no subjective benefit from supplemental oxygen


    • Control Group: (n = 22, 22 analysed): air by mask for 10 minutes
    Experimental Group: (n = 22, 22 analysed): 28% oxygen by mask for 10 minutes
    Each gas was given twice in a randomised sequence with a five minute washout period between the four study periods.
    100% followed for 10 minutes
    Outcome notes:
    • improvement in breathing : The patients were asked whether the gas helped his or her breathing (yes/ no), before removal of the face mask.

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNT
    (95% CI)
    improvement in breathing 10 minutes 21
    (47.7%)    		 35
    (79.6%)    		 61%
    (25% to 80%)    		 31.8%
    (12.9% to 50.8%)    		 3
    (2 to 8)

    COPD group
    Outcome Control Group
    (SD)    		 Experimental Group
    (SD)    		 Mean Difference
    (95% CI)
    SaO 2 85.1
    (8.0)     		93.1
    (4.8)     		8
    (2 to 14)
    dyspnoea (visual analogue scale) 29.6
    (15.6)     		45.5
    (20.7)     		-16
    (-31 to -0.38)

    Comments

    1. There may be differences in response with different underlying diagnoses.

    Citation

    1. Swinburn CR, Mould H, Stone TN, et al: symptomatic benefit of supplemental oxygen in hypoxemic patients with chronic lung disease. American Review of Respiratory Disease 1991; 143: 913-915
    Search Terms: COAD and therapy in Medline
    Contributor: Bob Phillips and Chris Ball, November 1999
    Reviewer: Peter Wark

    Clinical Question.
    Patient COPD with dyspnoea
    Intervention or Exposure supplemental oxygen
    Outcome improvement in symptoms