Oxygen breathing therapy for the relief of breathlessness in advanced terminal illness in adults

Cranston JM, Crockett A, Currow D

Published Online:

January 21, 2009

This review aimed to determine if oxygen therapy relieves breathlessness in end-stage illness in adults. No overall improvement of breathlessness in cancer study participants was found when oxygen breathing was compared to air breathing. However, some cancer study participants appeared to feel better breathing oxygen. Oxygen breathing slightly reduced breathlessness in two of three studies of heart failure participants after six minutes of exercise but the effect at peak exercise was uncertain. One small study found that breathing oxygen reduced breathlessness on exercise for study participants with severe curvature of the spine. The review was limited by the small number of studies, the small number of study participants and by the methods used in the studies.

Abstract (click to read)

Background:

Dyspnoea, or distressing breathing, is often a severe subjective symptom in terminal illness and may be difficult to control. Oxygen therapy is currently one of the interventions used to treat it. This review aimed to identify all randomised controlled studies (RCTs) in which oxygen therapy was used as a treatment to relieve dyspnoea in chronic terminal illness, and to synthesize the findings into a conclusion regarding the overall effectiveness of oxygen therapy for the palliation of dyspnoea in chronic terminal illness.

Objectives:

The objective of this review was to determine if oxygen therapy, administered in a non-acute care setting, provided additional relief of dyspnoea in study participants with chronic end-stage disease over that provided by breathing room air or placebo air as a control.

Search strategy:

Electronic databases were searched using predefined search terms. Searches were current to April 2006.

Selection criteria:

Only RCTs were considered for inclusion in this review. Unblinded studies were included.

Data collection and analysis:

Data was extracted by one review author and checked by another.

Main results:

Eight studies met the inclusion criteria for the review and included a total of 144 participants (cancer; n = 97, cardiac failure; n = 35, kyphoscoliosis; n = 12). Four cross-over studies, two studies with the participants at rest and two involving exercise testing, compared oxygen inhalation to air inhalation for dyspnoea management in adults with advanced cancer. Three cross-over studies compared the use of oxygen inhalation to air inhalation in adults with stable chronic heart failure for dyspnoea management during exercise testing and one crossover study compared ambulatory oxygen therapy with air inhalation on exercise-induced dyspnoea for study participants with kyphoscoliosis (a sideways and forwards curvature of the spine). No studies with matched or cohort controls were identified. Due to differences in study designs, few studies could be pooled for a meta-analysis.

This systematic review of the literature failed to demonstrate a consistent beneficial effect of oxygen inhalation over air inhalation for study participants with dyspnoea due to end-stage cancer or cardiac failure. Some cancer study participants appeared to feel better during oxygen inhalation.

Authors' conclusions:

The failure to demonstrate a beneficial effect for oxygen breathing over air breathing in cancer or cardiac failure was limited by the small volume of research studies available for inclusion, the small numbers of participants and by the methods used in the studies.

This record should be cited as:

Cranston JM, Crockett A, Currow D. Oxygen therapy for dyspnoea in adults. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD004769. DOI: 10.1002/14651858.CD004769.pub2

Assessed as up to date:

April 1, 2007

Find the research

Get full text at The Cochrane Library

Primary Review Group:

Pain, Palliative and Supportive Care Group

Health topics:

Cancer > Palliative and supportive care > Symptomatic relief

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Oxygen breathing therapy for the relief of breathlessness in advanced terminal illness in adults

More like this

Copyright © 2012 - The Cochrane Collaboration