A randomized controlled trial of supplemental oxygen versus air in cancer patients with dyspnea

• Published in: Palliative medicine 2003-12, Vol.17 (8), p.659-663
• Main Authors: Bruera, Eduardo, Sweeney, Catherine, Willey, Jie, Palmer, J Lynn, Strasser, Florian, Morice, Rodolfo C, Pisters, Katherine
• Format: Article
• Language: English
• Subjects: Adult; Aged; Air; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Gas Analysis; Cancer; Chronic Disease; Cross-Over Studies; Double-Blind Method; Dyspnea - prevention & control; Dyspnoea; Exercise Test; Fatigue - prevention & control; Female; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; Neoplasms - complications; Oxygen; Oxygen Inhalation Therapy - methods; Patients; Treatment
• ISSN: 0269-2163; 1477-030X
• DOI: 10.1191/0269216303pm826oa

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] / 90%) at rest and had a dyspnea intensity of] / 3 on a scale of 0–10 (03/4/no shortness of breath, 103/4/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.