[Long-term oxygen therapy (LTOT) in chronic obstructive lung disease (COL)].
A substantive amendment to this systematic review was last made on 12 April 1999. Cochrane reviews are regularly checked and updated if necessary.


OBJECTIVE
To determine the effect of domiciliary oxygen therapy on survival and quality of life in patients with chronic obstructive pulmonary disease.


METHODS
Randomised controlled trials (RTCs) were identified using the Cochrane Airways Group Chronic Obstructive Pulmonary Disease (COPD) register using the search terms: home or domiciliary and oxygen.


METHODS
Any randomised controlled trial in patients with hypoxia and chronic obstructive pulmonary disease that compared long term domiciliary or home oxygen therapy with a control treatment.


METHODS
Data extraction was performed independently by two reviewers.


RESULTS
Four randomised controlled trials were identified. Data from none of these trials could be aggrigated because of differences in trial design and patient selection. Trial 1, 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). Trial 2, oxygen versus no oxygen: there was a significant improvement over five years in mortality in the group receiving oxygen (Peto odds ratio 0.42, 95% confidence interval 0.18 to 0.98). Trial 3, nocturnal oxygen versus no oxygen in patients with arterial desaturation at night: there was no difference in mortality at 36 months. Trial 4, long term oxygen versus no oxygen in moderate hypoxaemia: there was no effect on survival for up to three years of follow up. REVIEWERS' CONCLUSION: Long term oxygen therapy improves survival in a selected group of COPD patients with severe hypoxaemia (arterial PO2 less than 8.0 kPa). Long term oxygen does not appear to improve survival in patients with moderate hypoxia or those who only have arterial desaturation at night.
Madsen
F F
FF
H:S Frederiksberg Hospital, Intern Medicinsk Klinik.flem-mad@dadlnet.dk
Jensen
L B
LB
D000075202:Contraindications; D003718:Denmark; D004992:Ethics, Medical; D019317:Evidence-Based Medicine; D006699:Home Care Services; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D010102:Oxygen Inhalation Therapy / Q000379:methods; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D013997:Time Factors