Shorter oxygen supply in severe COPD is enough to prolong survival
Patients with COPD who have recurrent problems with low oxygen levels, known as chronic hypoxaemia, only need oxygen therapy for 15 hours instead of a day or more as previously recommended. This is the result of a study in which Uppsala University Hospital participated. This means more freedom, as patients can be without oxygen treatment for nine hours of the day. Johnér photo agency/Johnér bildbyrå
Some patients with COPD have recurrent problems with a drop in oxygen levels affecting blood oxygen saturation, known as hypoxaemia. Prolonged oxygenation for at least 15 hours a day prolongs survival in those with severe, chronic hypoxaemia. However, prolonged treatment for 24 hours or more does not lead to a lower risk of hospitalisation or death within a year, according to a national study in which Uppsala University Hospital participated. Akademiska sjukhuset is drawing attention to this in a press release on the occasion of International COPD Day on November 118.
Professor Christer Janson, Consultant and Professor of Asthma and Allergy at Uppsala University Hospital.
'In the past, it has been recommended that COPD patients with severe, chronic hypoxaemia should be treated with prolonged oxygen therapy around the clock. Our study shows that 15 hours per day is sufficient. This means increased freedom for our patients who are treated with oxygen for a long time because they can now be without oxygen treatment nine hours of the day,’ says Christer Janson, chief physician and professor of lung and allergy diseases at Uppsala University Hospital.
In Sweden, 400 000-700 000 people have chronic obstructive pulmonary disease (COPD), a disease that affects the lungs and airways. Around 3 000 people die from the disease each year and the mortality rate is increasing, especially for women. The symptoms of the disease can be similar to asthma, but they come on more slowly, often over many years. Sufferers find it harder to breathe and have less energy than before. The disease can be difficult to detect as many people link their breathing difficulties to poor fitness or natural ageing.
The current multicentre study, published in the prestigious medical journal The New England Journal of Medicine (NEJM) from 2018-2022, is a registry-based, randomised controlled trial in which the researchers included a total of 241 patients from across Sweden with chronic severe hypoxaemia at rest. Patients were randomised into two groups to start long-term oxygen therapy for one day or 15 hours per day.
'Chronic hypoxia means that the lack of oxygen is permanent and that the oxygen pressure in the arterial blood (a measure of how well oxygen can move from the lungs to the blood) is constantly low. In Sweden, COPD is the most common cause of chronic hypoxia, but it also occurs in later stages of lung cancer, pulmonary fibrosis and pulmonary embolism, for example,’ Janson explains and continues:
'At the one-year follow-up, we saw that the risk of hospitalisation or death was not lower in the 24-hour group than in the 15-hour oxygen group. The incidence of hospitalisation did not differ significantly between the groups, nor did adverse events or all-cause death. No patient was lost during follow-up.'