COPD: continuous oxygen prevented death better than nocturnal oxygen

Clinical bottom line (level 1b)

  1. Patients with COPD and hypoxia who received continuous home oxygen compared with nocturnal oxygen were less likely to die (NNT = 6 at 19 months) .
Nocturnal Oxygen Therapy Trial Group : Annals of Internal Medicine 1980; 92: 391-398
Expires November 2003

The study

Double-blinded ?concealed randomised trial with intention-to-treat
Setting: 6 acute hospitals, USA

203 patients (aged mean 65, 79% male) with chronic obstructive lung disease (FEV1/FVC < 70%) and hypoxaemia (pO2 < 56 mmHg, or < 60 mmHg with oedema, haematocrit > 54% or p pulmonale on ECG)

Excluded if
  • aged < 35
  • previous oxygen therapy for 12 hours a day for 30 days during previous 2 months
  • other disease that might affect mortality


    • Note:
  • Patients were randomised in blocks of four.


    • Control Group: (n = 102, 102 analysed): nocturnal oxygen
    Experimental Group: (n = 101, 101 analysed): continuous oxygen therapy 1 to 4 l/min by nasal prongs to maintain pO 2 at 60 to 80 mmHg
    All patients were treated with oral theophyllines and inhaled beta-agonists.
    99% followed for 19 months

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNT
    (95% CI)
    death 19 months 41
    (40.2%)    		 23
    (22.8%)    		 43%
    (13% to 63%)    		 17.4%
    (4.88% to 30.0%)    		 6
    (3 to 21)

    Comments

    1. There is still no data to assist with patients who have nocturnal hypoxia alone.

    Citation

    1. Nocturnal Oxygen Therapy Trial Group , : Continuous of nocturnal oxygen therapy in hypoxemic chronic obstructive disease: a clinical trial. Annals of Internal Medicine 1980; 92: 391-398
    Search Terms: ?
    Contributor: Chris Ball and Clare Wotton, November 1999
    Reviewer: Mitsuhiro Kamei

    Clinical Question.
    Patient COPD and hypoxia
    Intervention or Exposure continuous oxygen
    Comparison nocturnal oxygen
    Outcome death