Wang Peijian, Wang Jing, Ge Lijun, Gao Beiyao, Wang Siyuan, Jiang Shan
Department of Rehabilitation Medicine, China-Japan Friendship Hospital, 2 Yinghuayuan East St. Hepingli, Chaoyang District, Beijing, 100029, China.
Department of Radiotherapy, Xuzhou Central Hospital, Xuzhou, JiangSu Province, China.
BMC Pulm Med. 2025 Mar 28;25(1):140. doi: 10.1186/s12890-025-03594-0.
Hypoxemia is a common symptom among patients with chronic obstructive pulmonary disease (COPD). The constant flow oxygen system (CFOS) is often insufficient to correct this symptom. The automatically titrating oxygen system (ATOS), a new oxygen therapy mode, remains undetermined in its ability to improve exercise performance more effectively than CFOS in COPD patients. The main objective of this meta-analysis was to explore this issue.
We conducted a thorough search of randomized controlled trials (RCTs) in PubMed, Embase, Web of Science (from inception to 1 November 2024). Study selection, data extraction, and risk of bias assessment were performed independently by two authors. Data synthesis was conducted using Stata software (Version 17.0). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was utilized to rate evidence quality.
Five eligible studies (n = 120) were included. Compared to CFOS, ATOS was more effective in extending the distance (MD = 180.28 m, 95%CI:133.03 to 227.52) and duration (MD = 237.63 s, 95%CI: 181.18 to 294.07) of endurance shuttle walking test (ESWT). Besides, ATOS could better prolong the percentage time of sustaining targeted SpO (92%-96%) (MD = 29.43%,95%CI:21.15 to 37.71) and relieve dyspnea at isotime (MD = -1.65, 95%CI -3.19 to -0.11) during ESWT.
ATOS may have more advantages in improving exercise tolerance, sustaining targeted SpO, and ameliorating dyspnea during exercise in COPD patients.
The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prosp ero/, and the ID is CRD 42024574955) and we didn't make a protocol.
低氧血症是慢性阻塞性肺疾病（COPD）患者的常见症状。持续流量氧气系统（CFOS）往往不足以纠正这一症状。自动滴定氧气系统（ATOS）作为一种新的氧疗模式，在COPD患者中比CFOS更有效地改善运动表现的能力仍未确定。本荟萃分析的主要目的是探讨这一问题。
我们在PubMed、Embase、Web of Science（从创刊到2024年11月1日）中对随机对照试验（RCT）进行了全面检索。研究选择、数据提取和偏倚风险评估由两位作者独立进行。使用Stata软件（版本17.0）进行数据合成。采用推荐分级、评估、制定和评价（GRADE）系统对证据质量进行评级。
纳入五项符合条件的研究（n = 120）。与CFOS相比，ATOS在延长耐力穿梭步行试验（ESWT）的距离（MD = 180.28米，95%CI：133.03至227.52）和持续时间（MD = 237.63秒，95%CI：181.18至294.07）方面更有效。此外，在ESWT期间，ATOS能更好地延长维持目标SpO₂（92%-96%）的时间百分比（MD = 29.43%，95%CI：21.15至37.71），并在等时间缓解呼吸困难（MD = -1.65，95%CI -3.19至-0.11）。
在改善COPD患者运动耐力、维持目标SpO₂以及缓解运动期间呼吸困难方面，ATOS可能具有更多优势。
该综述已在PROSPERO注册（网站为https://www.crd.york.ac.uk/prosp ero/，ID为CRD 42024574955），我们未制定方案。
