Ora Josuel, Coppola Angelo, Perduno Andrea, Manzetti Gian Marco, Puxeddu Ermanno, Rogliani Paola
Respiratory Medicine, Tor Vergata Hospital Foundation, Rome.
Respiratory Medicine, San Filippo Neri Hospital, Rome.
Monaldi Arch Chest Dis. 2021 Oct 11;92(2). doi: 10.4081/monaldi.2021.1925.
Ambulatory oxygen therapy (AOT) is commonly prescribed in interstitial lung disease (ILD) patients, with the aim of reducing dyspnea and increasing exercise tolerance. Despite its frequent use and a reasonable physiological rationale, there is a lack of evidence supporting the effect of AOT on improving dyspnea during exercise. Moreover, dyspnea encompasses distinct sensory (intensity, quality) and affective (anxiety, fear) components with different underlying neurophysiological mechanisms. The aim of this study was to evaluate the effect of oxygen supplementation on exercise tolerance and dyspnea in ILD patients with exercise induced hypoxia (EIH). Forty-seven ILD patients performed a six-minute walk test (6MWT) on room air (RA) and with oxygen supplementation (Ox). The 6MWT distance (6MWD) was significantly greater with oxygen supplementation (RA: 242±143 m vs Ox: 345±106 m p<0,01). With oxygen supplementation, the overall dyspnea and anxiety significantly decreased both at rest [1.1±1.4 Borg Unit (BU)] vs 0.4±0.9BU, p.<0.01, and 1.1±1.6BU vs 0.5±1.3 BU, p.<0.05, respectively) and at the end of exercise (5.1±2.6 BU vs 3.7±2.5 BU, p<0.001 and 3.4 ±2.9 vs 2.5±2.8, p.<0.01, respectively) despite a greater walked distance. In ILD patients with EIH, oxygen supplementation increases the exercise tolerance and reduces overall dyspnea perception and the anxiety component of breathlessness.
门诊氧疗（AOT）常用于间质性肺病（ILD）患者，目的是减轻呼吸困难并提高运动耐力。尽管其使用频繁且有合理的生理依据，但缺乏证据支持AOT对改善运动时呼吸困难的效果。此外，呼吸困难包括不同的感觉（强度、性质）和情感（焦虑、恐惧）成分，其潜在的神经生理机制不同。本研究的目的是评估补充氧气对运动性低氧（EIH）的ILD患者运动耐力和呼吸困难的影响。47例ILD患者在常氧（RA）和补充氧气（Ox）的情况下进行了6分钟步行试验（6MWT）。补充氧气时6MWT距离（6MWD）显著更长（RA：242±143米 vs Ox：345±106米，p<0.01）。补充氧气时，静息时总体呼吸困难和焦虑均显著降低[分别为1.1±1.4 Borg单位（BU） vs 0.4±0.9BU，p<0.01，以及1.1±1.6BU vs 0.5±1.3 BU，p<0.05]，运动结束时也显著降低（分别为5.1±2.6 BU vs 3.7±2.5 BU，p<0.001以及3.4±2.9 vs 2.5±2.8，p<0.01），尽管步行距离更长。在患有EIH的ILD患者中，补充氧气可提高运动耐力并降低总体呼吸困难感知以及呼吸急促的焦虑成分。
