Abstract
Introduction Exertion-Induced Desaturation (EID) is a common complication of numerous pulmonary disorders and often treated with supplementary oxygen during exertion. We performed a systematic review and meta-analysis of Randomized Clinical Trials (RCTs) to evaluate the efficacy of supplementary oxygen for EID in pulmonary disorders.
Material and methods Medline and Embase were systematically searched from July 2022 to June 2023 following PRISMA guidelines. RCTs that met predefined inclusion criteria were included. Means and Standard Deviations were extracted and Standardized Mean Differences (SMD), the difference in means between groups divided by the Standard Deviation, and 95% Confidence Intervals (CI) calculated. Exercise capacity was the primary outcome; exercise dyspnea, baseline dyspnea, quality of life were the secondary objectives. The immediate, post-rehabilitation, short-term, and ambulatory effects of oxygen supplementation were evaluated.
Results We included 15 studies in our analysis. Oxygen supplementation to treat EID had been investigated for Chronic Obstructive Pulmonary Disease (COPD) and Interstitial Pulmonary Fibrosis (IPF) only. Oxygen supplementation was superior to placebo for its immediate effect on exercise capacity for COPD (SMD: 0.42, 95% CI: 0.15 to 0.69, I2=3%) and IPF (SMD: 0.41, 95% CI: 0.08 to 0.75, I2=57%) and exercise dyspnea for COPD (SMD: −0.40, 95% CI: −0.76 to −0.04, I2=31%). Sensitivity analysis revealed similar results.
Conclusions Our study revealed efficacy of supplemental oxygen for EID and only a positive immediate effect on exercise capacity and dyspnea but no improvement in short-term or long-term measures.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: SA has received grants from Hoshi Iryo-Sanki Co. Ltd and NPO Central Japan Lung Study Group outside of the submitted work. SF has received grants from American Thoracic Society and Fisher & Paykel and has served as a consultant for Society of Hospital Medicine outside of the submitted work.
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- Received April 19, 2024.
- Accepted July 5, 2024.
- Copyright ©The authors 2024
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