Uronis Hope E, Abernethy Amy P
Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Curr Opin Support Palliat Care. 2008 Jun;2(2):89-94. doi: 10.1097/SPC.0b013e3282ff0f5d.
Refractory dyspnea is a common and distressing symptom complicating respiratory illness, including chronic obstructive pulmonary disease, and life-limiting illnesses in general, including cancer. Oxygen is often prescribed for relief of dyspnea and several consensus guidelines support this practice. The goal of this review is to outline the evidence for the use of oxygen for relief of dyspnea, with specific attention to situations in which oxygen is not already funded through long-term oxygen treatment guidelines (i.e., when PaO2 is >/=55 mmHg; also known as palliative oxygen).
Several recent systematic reviews, two focusing on people with chronic obstructive pulmonary disease and the other focusing on people with cancer, strengthen the evidence base behind the use of palliative oxygen for relief of refractory dyspnea, and support the observation that there are subgroups of people who benefit from oxygen, such as individuals with chronic obstructive pulmonary disease.
The data highlighted in this review support the belief that certain individuals benefit from the use of palliative oxygen but continue to suggest that definitive randomized trials are required to fully establish the benefit of palliative oxygen and to delineate characteristics predictive of benefit.
难治性呼吸困难是一种常见且令人痛苦的症状，会使包括慢性阻塞性肺疾病在内的呼吸系统疾病以及包括癌症在内的一般限制生命的疾病复杂化。氧气常被用于缓解呼吸困难，多项共识指南支持这种做法。本综述的目的是概述使用氧气缓解呼吸困难的证据，特别关注那些尚未通过长期氧疗指南获得资金支持的情况（即当动脉血氧分压≥55mmHg时；也称为姑息性给氧）。
最近的几项系统综述，其中两项聚焦于慢性阻塞性肺疾病患者，另一项聚焦于癌症患者，强化了使用姑息性给氧缓解难治性呼吸困难的证据基础，并支持这样的观察结果，即存在从氧气中获益的亚组人群，如慢性阻塞性肺疾病患者。
本综述中强调的数据支持这样一种观点，即某些个体从使用姑息性给氧中获益，但仍表明需要进行确定性随机试验，以充分确立姑息性给氧的益处并确定预测获益的特征。
