Ahmadi Zainab, Smallwood Natasha E, Russell Anne-Marie, Saggu Ravijyot, Romero Lorena, Holland Anne E, Ekström Magnus
Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
Department of Respiratory Medicine, Alfred Health, Melbourne, Australia.
Eur Respir Rev. 2025 Mar 5;34(175). doi: 10.1183/16000617.0025-2024. Print 2025 Jan.
People with serious respiratory illness frequently have a high symptom burden and may be prescribed supplemental oxygen therapy with the aims of reducing the severity of breathlessness and improving health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to assess the effectiveness of oxygen therapy no oxygen on 1) breathlessness, 2) HRQoL and 3) adverse events.
A comprehensive search was performed in Embase, Medline and the Cochrane Central Register of Controlled Trials for randomised controlled trials published prior to June 2022. We used the Cochrane Risk of Bias Tool for appraising the studies and conducted random-effect meta-analyses when appropriate. We pooled effects recorded on different scales as standardised mean differences (SMDs) with 95% confidence intervals. Lower SMDs indicated decreased breathlessness or HRQoL. We assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework.
We found that supplemental oxygen (compared with sham air or no treatment), reduced breathlessness intensity during laboratory exercise testing (SMD -0.75, 95% CI -1.23--0.28, 12 randomised control trials (RCTs), 245 participants), but had no shown effect on breathlessness measured in daily life (SMD -0.08, 95% CI -0.41-0.26, one RCT, 213 participants) or HRQoL (SMD -0.06, -0.17-0.05, 14 RCTs, 1062 participants). Few or no adverse events related to oxygen therapy were reported. For all the outcomes, the certainty of evidence was low.
Oxygen improved exertional breathlessness in laboratory-based exercise studies but was not shown to improve breathlessness or HRQoL in daily life.
患有严重呼吸系统疾病的人通常症状负担较重，可能会接受补充氧气治疗，目的是减轻呼吸急促的严重程度并改善健康相关生活质量（HRQoL）。本系统评价和荟萃分析旨在评估氧气治疗（与无氧气治疗相比）对1）呼吸急促、2）健康相关生活质量和3）不良事件的有效性。
在Embase、Medline和Cochrane对照试验中央登记册中进行了全面检索，以查找2022年6月之前发表的随机对照试验。我们使用Cochrane偏倚风险工具评估研究，并在适当的时候进行随机效应荟萃分析。我们将不同量表上记录的效应合并为标准化均数差（SMD），并给出95%置信区间。较低的SMD表明呼吸急促或健康相关生活质量降低。我们使用推荐分级、评估、制定和评价框架评估证据的确定性。
我们发现，补充氧气（与假空气或无治疗相比）在实验室运动测试期间降低了呼吸急促强度（SMD -0.75，95% CI -1.23--0.28，12项随机对照试验（RCT），245名参与者），但对日常生活中测量的呼吸急促（SMD -0.08，95% CI -0.41 - 0.26，1项RCT，213名参与者）或健康相关生活质量（SMD -0.06，-0.17 - 0.05，14项RCT，1062名参与者）没有显示出效果。很少或没有报告与氧气治疗相关的不良事件。对于所有结局，证据的确定性都很低。
在基于实验室的运动研究中，氧气改善了运动性呼吸急促，但在日常生活中并未显示出能改善呼吸急促或健康相关生活质量。
Zotero 插件
