On Oxygen Therapy:
Why are there so few, if any reports or updates, on clinical research concerning the use of supplemental oxygen? For example one of the many reports on its possible long-term toxicity with resulting damage to the lungs.
A report on a fairly recent controlled 8-week trial with 111 participants (European Respiratory Journal, 2018) with moderate to severe COPD showed NO DIFFERENCE in the improvement of exercise capacity or health-related quality of life between patients given supplemental OXYGEN through nasal prongs from O2 concentrators, and those who - unkown them - were just given ordinary AIR.
Surely a significant result, and one which should raise questions???
The LOTT study in the US was a long term study of O2 usage among people with moderate COPD, who were on the cusp of needing O2 (O2 sats between 88 and 92). They randomly gave those folks O2 or not and the study showed exactly what the study you looked at showed. The LOTT study was the topic in one of the general sessions at ATS in 2016 and believe me, the questions were raised! There were significant flaws in the study; enough to make most docs in attendance at the session say that regardless of the findings, they would still offer O2 to those in that category who asked for it and would still prescribe O2 for anyone whose saturation level dipped below 88.
The big problem with studying O2 is how do you deny people whose sats are at 88 or below O2? You can't maintain that over time, even if you could do it short-term. You also have to remember, as I pointed out to the primary docs on the LOTT study at ATS in 2016, the point of O2 is to keep the O2 saturation levels up to avoid right heart failure and brain damage, not to necessarily make it possible for people to breathe easier or exercise harder.
The LOTT folks hoped to make the point that adding O2 to these people at the "cusp" of needing O2 would increase their exercise ability, make breathing easier, help them do more in their daily lives, etc. One of the flaws in the study was that people who did want to achieve more weren't willing to give up the O2 they already had. I was one of many patient using O2 who would have fit the criteria for the study and there was no way I would have given mine up. I know without it I couldn't have begun to do what I wanted to do in the gym or in my life without it.
The consensus generally is that the LOTT was interesting and for that particular group of people (with sats between 92 and 88) were perhaps significant, but there were enough flaws in the study to make its findings suspect. I haven't read the study you cite, but it sounds like exactly the same thing.
LOTT study: https://www.nejm.org/doi/full/10.1056/NEJMoa(Phone number can only be seen by the question and answer creators)
@A MyCOPDTeam Member Thank you very much for your take on this subject ! I for one would not do well with out oxygen as a result I am glad to have it available to me ! Thanks again Jean !
Very interesting. Did the 111 subjects in the study have significant reductions in their oxygen diffusion capacity?
I'm going to try and find this study.
@A MyCOPDTeam Member Thanks very much for this Jean. It seems the main difference between the interesting LOTT study you refer to, and the one I found on the European Respiratory Journal was that the ERP study was a controlled double-blind study in which neither physicians nor researchers knew if the patients were getting oxygen or medical air via their canulas, i.e. a sort of 'O2 versus placebo' experiment. It was also specifically for patients who experienced O2 desaturation during exercise. Conclusion was that exercise capacity improved in both 02 and 'placebo' group.
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