机构:
Sheffield Childrens Hosp, Resp Unit, Sheffield S10 2TH, S Yorkshire, EnglandSheffield Childrens Hosp, Resp Unit, Sheffield S10 2TH, S Yorkshire, England
Elphick, Heather E.
[1
]
Mallory, George
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机构:
Texas Childrens Hosp, Baylor Coll Med, Houston, TX 77030 USASheffield Childrens Hosp, Resp Unit, Sheffield S10 2TH, S Yorkshire, England
Mallory, George
[2
]
机构:
[1] Sheffield Childrens Hosp, Resp Unit, Sheffield S10 2TH, S Yorkshire, England
Background The most serious complications of cystic fibrosis (CF) relate to respiratory insufficiency. Oxygen supplementation therapy has long been a standard of care for individuals with chronic lung diseases associated with hypoxemia. Physicians commonly prescribe oxygen therapy for people with CF when hypoxemia occurs. However, it is unclear if empiric evidence is available to provide indications for this therapy with its financial costs and often profound impact on lifestyle. Objectives To assess whether oxygen therapy improves the longevity or quality of life of individuals with CF. Search methods We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register, comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Latest search of Group's Trials Register: 15 May 2013. Selection criteria Randomized or quasi-randomized controlled trials comparing oxygen, administered at any concentration, by any route, in people with documented CF for any time period. Data collection and analysis Authors independently assessed the risk of bias for included studies and extracted data. Main results This review includes 11 published studies (172 participants); only one examined long-term oxygen therapy (28 participants). There was no statistically significant improvement in survival, lung, or cardiac health. There was an improvement in regular attendance at school or work in those receiving oxygen therapy at 6 and 12 months. Four studies examined the effect of oxygen supplementation during sleep by polysomnography. Although oxygenation improved, mild hypercapnia was noted. Participants fell asleep quicker and spent a reduced percentage of total sleep time in rapid eyemovement sleep, but there were no demonstrable improvements in qualitative sleep parameters. Six studies evaluated oxygen supplementation during exercise. Again, oxygenation improved, but mild hypercapnia resulted. Participants receiving oxygen therapy were able to exercise for a significantly longer duration during exercise. Other exercise parameters were not altered by the use of oxygen. Authors' conclusions There are no published data to guide the prescription of chronic oxygen supplementation to people with advanced lung disease due to CF. Short-term oxygen therapy during sleep and exercise improves oxygenation but is associated with modest and probably clinically inconsequential hypercapnia. There are improvements in exercise duration, time to fall asleep and regular attendance at school or work. There is a need for larger, well-designed clinical trials to assess the benefits of long-term oxygen therapy in people with CF administered continuously or during exercise or sleep or both.
机构:
Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA
Stanley Manne Childrens Res Inst, Chicago, IL USA
Northwestern Univ, Clin & Translat Sci Inst, Chicago, IL 60611 USA
Ann & Robert H Lurie Childrens Hosp Chicago, Cyst Fibrosis Ctr, Div Pulm Med, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA
机构:
Natl Heart & Lung Inst, Imperial Coll, Ion Transport Unit, Dept Gene Therapy, London SW3 6LR, EnglandNatl Heart & Lung Inst, Imperial Coll, Ion Transport Unit, Dept Gene Therapy, London SW3 6LR, England
Kitson, C
Alton, E
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Natl Heart & Lung Inst, Imperial Coll, Ion Transport Unit, Dept Gene Therapy, London SW3 6LR, EnglandNatl Heart & Lung Inst, Imperial Coll, Ion Transport Unit, Dept Gene Therapy, London SW3 6LR, England