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A randomized controlled trial of supplemental oxygen versus air in cancer patients with dyspnea
Eduardo Bruera
Catherine Sweeney
Jie Willey
J Lynn Palmer
Florian Strasser
Rodolfo C Morice
Katherine Pisters
The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
Context: The symptomatic benefits of oxygen in patients with cancer who have nonhypoxic dyspnea are not well defined.
Objective: To determine whether or not oxygen is more effective than air in decreasing dyspnea and fatigue and increasing distance walked during a 6-minute walk test.
Patients and methods: Patients with advanced cancer who had no severe hypoxemia (i.e., had an O2 saturation level of] / 90%) at rest and had a dyspnea intensity of] / 3 on a scale of 0–10 (03/4/no shortness of breath, 103/4/worst imaginable shortness of breath) were recruited from an outpatient thoracic clinic at a comprehensive cancer center. This was a double-blind, randomized crossover trial. Supplemental oxygen or air (5 L/min) was administered via nasal cannula during a 6-minute walk test. The outcome measures were dyspnea at 3 and 6 minutes, fatigue at 6 minutes, and distance walked. We also measured oxygen saturation levels at baseline, before second treatment phase, and at the end of study.
Results: In 33 evaluable patients (31 with lung cancer), no significant differences between treatment groups were observed in dyspnea, fatigue, or distance walked (dyspnea at 3 minutes: P = 0.61; dyspnea, fatigue, and distance walked at 6 minutes: P = 0.81, 0.37, and 0.23, respectively).
Conclusions: Currently, the routine use of supplemental oxygen for dyspnea during exercise in this patient population cannot be recommended.
Key Words: air • cancer • dyspnea • oxygen
Palliative Medicine, Vol. 17, No. 8,
659-663 (2003)
DOI: 10.1191/0269216303pm826oa
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