CONTEXT: The symptomatic benefits of oxygen in patients with cancer who have nonhypoxic dyspnea are not well defined. OBJECTIVE: To determine whether or not oxygen is more effective than air in decreasing dyspnea and fatigue and increasing distance walked during a 6-minute walk test. PATIENTS AND METHODS: Patients with advanced cancer who had no severe hypoxemia (i.e., had an O2 saturation level of > or = 90%) at rest and had a dyspnea intensity of > or = 3 on a scale of 0-10 (0 = no shortness of breath, 10 = worst imaginable shortness of breath) were recruited from an outpatient thoracic clinic at a comprehensive cancer center. This was a double-blind, randomized crossover trial. Supplemental oxygen or air (5 L/min) was administered via nasal cannula during a 6-minute walk test. The outcome measures were dyspnea at 3 and 6 minutes, fatigue at 6 minutes, and distance walked. We also measured oxygen saturation levels at baseline, before second treatment phase, and at the end of study. RESULTS: In 33 evaluable patients (31 with lung cancer), no significant differences between treatment groups were observed in dyspnea, fatigue, or distance walked (dyspnea at 3 minutes: P = 0.61; dyspnea, fatigue, and distance walked at 6 minutes: P = 0.81, 0.37, and 0.23, respectively). CONCLUSIONS: Currently, the routine use of supplemental oxygen for dyspnea during exercise in this patient population cannot be recommended.
RCT Entities:
CONTEXT: The symptomatic benefits of oxygen in patients with cancer who have nonhypoxic dyspnea are not well defined. OBJECTIVE: To determine whether or not oxygen is more effective than air in decreasing dyspnea and fatigue and increasing distance walked during a 6-minute walk test. PATIENTS AND METHODS: Patients with advanced cancer who had no severe hypoxemia (i.e., had an O2 saturation level of > or = 90%) at rest and had a dyspnea intensity of > or = 3 on a scale of 0-10 (0 = no shortness of breath, 10 = worst imaginable shortness of breath) were recruited from an outpatient thoracic clinic at a comprehensive cancer center. This was a double-blind, randomized crossover trial. Supplemental oxygen or air (5 L/min) was administered via nasal cannula during a 6-minute walk test. The outcome measures were dyspnea at 3 and 6 minutes, fatigue at 6 minutes, and distance walked. We also measured oxygen saturation levels at baseline, before second treatment phase, and at the end of study. RESULTS: In 33 evaluable patients (31 with lung cancer), no significant differences between treatment groups were observed in dyspnea, fatigue, or distance walked (dyspnea at 3 minutes: P = 0.61; dyspnea, fatigue, and distance walked at 6 minutes: P = 0.81, 0.37, and 0.23, respectively). CONCLUSIONS: Currently, the routine use of supplemental oxygen for dyspnea during exercise in this patient population cannot be recommended.
Authors: Amy P Abernethy; Christine F McDonald; Peter A Frith; Katherine Clark; James E Herndon; Jennifer Marcello; Iven H Young; Janet Bull; Andrew Wilcock; Sara Booth; Jane L Wheeler; James A Tulsky; Alan J Crockett; David C Currow Journal: Lancet Date: 2010-09-04 Impact factor: 79.321
Authors: Andrew S Epstein; Sidonie K Hartridge-Lambert; Judson S Ramaker; Louis P Voigt; Carol S Portlock Journal: J Palliat Med Date: 2011-05-20 Impact factor: 2.947
Authors: Hugh Ej Senior; Geoffrey K Mitchell; Jane Nikles; Sue-Ann Carmont; Philip J Schluter; David C Currow; Rohan Vora; Michael J Yelland; Meera Agar; Phillip D Good; Janet R Hardy Journal: BMC Palliat Care Date: 2013-04-23 Impact factor: 3.234