Bell Emily C, Cox Narelle S, Goh Nicole, Glaspole Ian, Westall Glen P, Watson Alice, Holland Anne E
Dept of Physiotherapy, Monash University, Clayton, Australia.
Dept of Physiotherapy, La Trobe University, Melbourne, Australia.
Eur Respir Rev. 2017 Feb 21;26(143). doi: 10.1183/16000617.0080-2016. Print 2017 Jan.
This review aims to establish the impact of oxygen therapy on dyspnoea, health-related quality of life (HRQoL), exercise capacity and mortality in interstitial lung disease (ILD).We included studies that compared oxygen therapy to no oxygen therapy in adults with ILD. No limitations were placed on study design or intervention type. Two reviewers independently evaluated studies for inclusion, assessed risk of bias and extracted data. The primary outcome was dyspnoea.Eight studies evaluated the acute effects of oxygen (n=1509). There was no effect of oxygen therapy on modified Borg dyspnoea score at end exercise (mean difference (MD) -0.06 units, 95% CI -0.24-0.13; two studies, n=27). However, effects on exercise outcomes consistently favoured oxygen therapy. One study showed reduction in dyspnoea at rest with oxygen in patients who were acutely unwell (MD visual analogue scale 30 mm 48 mm, p<0.05; n=10). Four studies of long-term oxygen therapy (n=2670) had high risk of bias and no inferences could be drawn.This systematic review showed no effects of oxygen therapy on dyspnoea during exercise in ILD, although exercise capacity was increased. Future trials should evaluate whether acute improvements in exercise capacity with oxygen can be translated into improved physical activity and HRQoL.
本综述旨在确定氧疗对间质性肺疾病(ILD)患者的呼吸困难、健康相关生活质量(HRQoL)、运动能力和死亡率的影响。我们纳入了比较氧疗与未进行氧疗的成年ILD患者的研究。对研究设计或干预类型未设限制。两名评审员独立评估研究是否纳入,评估偏倚风险并提取数据。主要结局为呼吸困难。八项研究评估了氧疗的急性效应(n = 1509)。氧疗对运动结束时改良Borg呼吸困难评分无影响(平均差值(MD)-0.06单位,95%置信区间-0.24至0.13;两项研究,n = 27)。然而,对运动结局的影响始终有利于氧疗。一项研究表明,急性不适患者吸氧后静息时呼吸困难减轻(视觉模拟量表MD:30 mm对48 mm,p<0.05;n = 10)。四项长期氧疗研究(n = 2670)存在高偏倚风险,无法得出结论。本系统评价表明,氧疗对ILD患者运动期间的呼吸困难无影响,尽管运动能力有所提高。未来的试验应评估吸氧导致的运动能力急性改善是否能转化为体力活动和HRQoL的改善。