Continuous oxygen use in nonhypoxemic emphysema patients identifies a high-risk subset of patients - Retrospective analysis of the National Emphysema Treatment Trial
Continuous oxygen use in nonhypoxemic emphysema patients identifies a high-risk subset of patients - Retrospective analysis of the National Emphysema Treatment Trial
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DOI：
10.1378/chest.08-0117
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发表时间：
2008-09-01
期刊：
影响因子：
9.6
通讯作者：
Wise, Robert A.
中科院分区：
文献类型：
--
作者：
Drummond, Michael B.;Blackford, Amanda L.;Wise, Robert A.
背景：对于静息时没有低氧血症的肺气肿患者，不推荐持续氧疗，尽管经常进行这种治疗。对于使用持续吸氧的非低氧性肺气肿患者的临床特征和生存情况知之甚少。对国家肺气肿治疗试验 (NETT) 数据的分析提供了对该人群的深入了解。方法：我们分析了 1,215 名 NETT 参与者的人口统计和临床特征，根据静息 Pao(2) 和报告的氧气使用情况进行分层。对随机接受药物治疗的个体进行了八年生存率评估。结果：入组时，33.8%（n = 260）的休息时无低氧血症的参与者报告持续吸氧。与不使用氧气的非低氧血症个体 (n = 226) 相比，使用持续吸氧的个体呼吸困难更严重，生活质量更低，运动去饱和更频繁，病死率更高。在调整饲料、体重指数和预测的 FEV1 百分比后，运动去饱和度的存在导致了这些组之间死亡率的差异。结论：在 NETT 中，静息非低氧性肺气肿患者使用持续吸氧与较差的疾病严重程度和生存率相关。观察到的生存率差异几乎全部都是由使用连续吸氧的人运动去饱和发生率较高所致，这表明氧疗并不是导致死亡的有害影响。持续氧疗是否能提高运动饱和度正常的患者的生存率仍然是一个核心问题。试验注册：Clinicaltrials.gov 标识符：NCT00000606。
Background: Continuous oxygen therapy is not recommended for emphysema patients who are not hypoxemic at rest, although it is often prescribed. Little is known regarding the clinical characteristics and survival of nonhypoxemic emphysema patients using continuous oxygen. Analysis of data from the National Emphysema Treatment Trial (NETT) offers insight into this population.Methods: We analyzed demographic and clinical characteristics of 1,215 participants of NETT, stratifying by, resting Pao(2) and reported oxygen use. Eight-year survival was evaluated in individuals randomized to medical therapy.Results: At enrollment, 33.8% (n = 260) of participants nonhypoxemic at rest reported continuous oxygen use. When compared to nonhypoxemic individuals not using oxygen (n = 226), those using continuous oxygen had worse dyspnea, lower quality of life, more frequent exercise desaturation, and higher case-fatality rate. After adjusting forage, body mass index, and FEV1 percentage of predicted, the presence of exercise desaturation accounted Cor the differential mortality seen between these groups.Conclusions: In the NETT, the use of continuous oxygen in resting nonhypoxemic emphysema patients was associated with worse disease severity and survival. The differential survival observed could nearly, all be accounted for by the higher prevalence of exercise desaturation in those using continuous oxygen, suggesting that it is not a harmful effect of oxygen therapy contributing to mortality. it remains nuclear whether continuous oxygen therapy, improves survival in normoxic patients with exercise desaturation.Trial registration: Clinicaltrials.gov Identifier: NCT00000606.