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ERS: Palliative Nasal Oxygen No Better Than Room Air

Routine oxygen therapy does not relieve breathlessness in dyspneic terminally ill patients

FRIDAY, Sept. 3 (HealthDay News) -- Palliative supplemental oxygen delivered by nasal cannula does not relieve breathlessness in terminally ill patients with refractory dyspnea but an adequate baseline partial pressure of oxygen in arterial blood (PaO2), according to a study published in the Sept. 4 issue of The Lancet in advance of the European Respiratory Society Annual Congress, to be held from Sept. 18 to 22 in Barcelona, Spain.

Amy P. Abernethy, M.D., of the Duke University Medical Center in Durham, N.C., and colleagues conducted a double-blind, randomized controlled trial of nasal cannula palliative oxygen given at 2 L per min, or room-air placebo also delivered by nasal cannula, to patients with terminal illnesses and refractory dyspnea. The participants' baseline PaO2 was more than 7.3 kPa. One hundred twelve patients who received oxygen and 99 who received room air completed one week of assessments.

After six days, the researchers found that the mean morning breathless scores had decreased by 0.9 in the oxygen group and by 0.7 in the placebo group (P = 0.504). Mean evening breathlessness scores were also not significantly different for the two groups (score change of −0.3 and −0.5 in the oxygen and placebo groups, respectively). Extreme drowsiness was reported in 10 percent of the oxygen patients and 13 percent of the placebo patients. Overall, the frequency of side effects did not differ between the groups.

"High-quality care for people with life-limiting illness and refractory symptoms requires the judicious use of interventions that provide greatest patient-defined benefit with least harm. Palliative oxygen does not provide incremental benefit over room air when provided at 2 L per min by a nasal cannula, for patients with PaO2 more than 7.3 kPa," the authors write.

Two authors disclosed financial relationships with the pharmaceutical industry.

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