Domiciliary oxygen for chronic obstructive pulmonary disease (Cochrane Review)

A substantive amendment to this systematic review was last made on 08 June 2000. Cochrane reviews are regularly checked and updated if necessary.

Background: Domiciliary oxygen therapy has become one of the major forms of treatment for hypoxaemic chronic obstructive pulmonary disease (COPD) patients.

Objectives: To determine the effect of domiciliary oxygen therapy on survival and quality of life in patients with COPD.

Search strategy: Randomised controlled trials (RCTs) were identified using the Cochrane Airways Group COPD register using the search terms: home OR domiciliary AND oxygen.

Selection criteria: Any RCT in patients with hypoxaemia and COPD that compared long term domiciliary or home oxygen therapy with a control treatment.

Data collection and analysis: Data extraction was performed independently by two reviewers.

Main results: Five randomised controlled trials were identified. Data was aggregated from two trials of the treatment of nocturnal oxygen therapy in patients with mild to moderate COPD and arterial desaturation at night. Data could not be aggregated for the other three trials because of differences in trial design and patient selection. Nott 1980: continuous oxygen therapy versus nocturnal oxygen therapy: there was a significant improvement in mortality after 24 months (Peto odds ratio 0.45, 95% confidence interval 0.25 to 0.81). MRC 1981: domiciliary oxygen therapy versus no oxygen therapy: there was a significant improvement over five years in mortality in the group receiving oxygen therapy (Peto odds ratio 0.42, 95% confidence interval 0.18 to 0.98). In two studies of nocturnal oxygen versus no oxygen in patients with COPD and arterial desaturation at night: there was no difference in mortality between treated and non treated groups for either trial or when the trials were aggregated. In one study of long term oxygen versus no oxygen in moderate hypoxaemia: there was no effect on survival for up to three years of follow up. An update search conducted in January 2003 did not identify any further studies for inclusion in the review.

Reviewers' conclusions: Long term oxygen therapy improved survival in a selected group of COPD patients with severe hypoxaemia (arterial PO2 less than 8.0 kPa). Long term oxygen did not appear to improve survival in patients with moderate hypoxaemia or in those with only arterial desaturation at night.

Citation: Crockett AJ, Cranston JM, Moss JR, Alpers JH. Domiciliary oxygen for chronic obstructive pulmonary disease (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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