https://doi.org/10.4081/monaldi.2021.1925
Acute effect of oxygen therapy on exercise tolerance and dyspnea perception in ILD patients
Submitted: May 12, 2021
Accepted: September 6, 2021
Published: October 11, 2021
Accepted: September 6, 2021
Abstract Views: 1286
PDF: 596
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Ambulatory oxygen therapy (AOT) is commonly prescribed in interstitial lung disease (ILD) patients, with the aim of reducing dyspnea and increasing exercise tolerance. Despite its frequent use and a reasonable physiological rationale, there is a lack of evidence supporting the effect of AOT on improving dyspnea during exercise. Moreover, dyspnea encompasses distinct sensory (intensity, quality) and affective (anxiety, fear) components with different underlying neurophysiological mechanisms. The aim of this study was to evaluate the effect of oxygen supplementation on exercise tolerance and dyspnea in ILD patients with exercise induced hypoxia (EIH). Forty-seven ILD patients performed a six-minute walk test (6MWT) on room air (RA) and with oxygen supplementation (Ox). The 6MWT distance (6MWD) was significantly greater with oxygen supplementation (RA: 242±143 m vs Ox: 345±106 m p<0,01). With oxygen supplementation, the overall dyspnea and anxiety significantly decreased both at rest [1.1±1.4 Borg Unit (BU)] vs 0.4±0.9BU, p.<0.01, and 1.1±1.6BU vs 0.5±1.3 BU, p.<0.05, respectively) and at the end of exercise (5.1±2.6 BU vs 3.7±2.5 BU, p<0.001 and 3.4 ±2.9 vs 2.5±2.8, p.<0.01, respectively) despite a greater walked distance. In ILD patients with EIH, oxygen supplementation increases the exercise tolerance and reduces overall dyspnea perception and the anxiety component of breathlessness.
Hardinge M, Annandale J, Bourne S, et al. British Thoracic Society guidelines for home oxygen use in adults. Thorax 2015;70:i1-43.
DOI: https://doi.org/10.1136/thoraxjnl-2015-206865
O’Donnell DE, Ora J, Webb KA S, et al. Mechanisms of activity-related dyspnea in pulmonary diseases. Respir Physiol Neurobiol 2009;167:116–32.
DOI: https://doi.org/10.1016/j.resp.2009.01.010
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166:111–7.
DOI: https://doi.org/10.1164/ajrccm.166.1.at1102
Palange P, Forte S, Onorati P, et al. Ventilatory and metabolic adaptations to walking and cycling in patients with COPD. J Appl Physiol (1985) 2000;88:1715–20.
DOI: https://doi.org/10.1152/jappl.2000.88.5.1715
Poulain M, Durand F, Palomba B, et al. 6-minute walk testing is more sensitive than maximal incremental cycle testing for detecting oxygen desaturation in patients with COPD. Chest 2003;123:1401–7.
DOI: https://doi.org/10.1378/chest.123.5.1401
Bradley JM, O’Neill B. Short-term ambulatory oxygen for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2005;(4):CD004356.
DOI: https://doi.org/10.1002/14651858.CD004356.pub2
Nishiyama O, Miyajima H, Fukai Y, et al. Effect of ambulatory oxygen on exertional dyspnea in IPF patients without resting hypoxemia. Respir Med 2013;107:1241–6.
DOI: https://doi.org/10.1016/j.rmed.2013.05.015
Frank RC, Hicks S, Duck AM, et al. Ambulatory oxygen in idiopathic pulmonary fibrosis: of what benefit? Eur Respir J 2012;40:269–70.
DOI: https://doi.org/10.1183/09031936.00007712
Visca D, Montgomery A, de Lauretis A, et al. Ambulatory oxygen in interstitial lung disease. Eur Respir J 2011;38:987–90.
DOI: https://doi.org/10.1183/09031936.00190710
Bell EC, Cox NS, Goh N, et al. Oxygen therapy for interstitial lung disease: a systematic review. Eur Respir Rev 2017;26:160080.
DOI: https://doi.org/10.1183/16000617.0080-2016
Khor YH, Renzoni EA, Visca D, et al. Oxygen therapy in COPD and interstitial lung disease: navigating the knowns and unknowns. ERJ Open Res 2019;5:00118-2019.
DOI: https://doi.org/10.1183/23120541.00118-2019
Parshall MB, Schwartzstein RM, Adams L, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med 2012;185:435–52.
DOI: https://doi.org/10.1164/rccm.201111-2042ST
Marciniuk DD, Watts RE, Gallagher CG. Dead space loading and exercise limitation in patients with interstitial lung disease. Chest 1994;105:183–9.
DOI: https://doi.org/10.1378/chest.105.1.183
O’Donnell DE, Chau LK, Webb KA. Qualitative aspects of exertional dyspnea in patients with interstitial lung disease. J Appl Physiol (1985) 1998;84:2000–9.
DOI: https://doi.org/10.1152/jappl.1998.84.6.2000
Faisal A, Alghamdi BJ, Ciavaglia CE, et al. Common mechanisms of dyspnea in chronic interstitial and obstructive lung disorders. Am J Respir Crit Care Med 2016;193:299–309.
DOI: https://doi.org/10.1164/rccm.201504-0841OC
Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319–38.
DOI: https://doi.org/10.1183/09031936.05.00034805
Quanjer PH, Tammeling GJ, Cotes JE, et al. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 1993;16:5–40.
DOI: https://doi.org/10.1183/09041950.005s1693
Ora J, Calzetta L, Pezzuto G, et al. A 6MWT index to predict O2 flow correcting exercise induced SpO2 desaturation in ILD. Respir Med 2013;107:2014–21.
DOI: https://doi.org/10.1016/j.rmed.2013.10.002
Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med 1998;158:1384–7.
DOI: https://doi.org/10.1164/ajrccm.158.5.9710086
Stoller JK, Ferranti R, Feinstein AR. Further specification and evaluation of a new clinical index for dyspnea. Am Rev Respir Dis 1986;134:1129–34.
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982;14:377–81.
DOI: https://doi.org/10.1249/00005768-198205000-00012
Raghu G, Rochwerg B, Zhang Y, et al. An Official ATS/ERS/JRS/ALAT clinical practice guideline: Treatment of idiopathic pulmonary fibrosis. An update of the 2011 clinical practice guideline. Am J Respir Crit Care Med 2015;192:e3-19.
DOI: https://doi.org/10.1164/rccm.201506-1063ST
Celli BR, MacNee W, ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23:932–46.
DOI: https://doi.org/10.1183/09031936.04.00014304
Swinburn CR, Wakefield JM, Jones PW. Relationship between ventilation and breathlessness during exercise in chronic obstructive airways disease is not altered by prevention of hypoxaemia. Clin Sci (Lond) 1984;67:515–9.
DOI: https://doi.org/10.1042/cs0670515
Cranston JM, Crockett A, Currow D. Oxygen therapy for dyspnoea in adults. Cochrane Database Syst Rev 2008;(3):CD004769.
DOI: https://doi.org/10.1002/14651858.CD004769.pub2
McKeon JL, Murree-Allen K, Saunders NA. Effects of breathing supplemental oxygen before progressive exercise in patients with chronic obstructive lung disease. Thorax 1988;43:53–6.
DOI: https://doi.org/10.1136/thx.43.1.53
Abernethy AP, McDonald CF, Frith PA, et al. Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial. Lancet 2010;376:784–93.
DOI: https://doi.org/10.1016/S0140-6736(10)61115-4
O’Donnell DE, D’Arsigny C, Webb KA. Effects of hyperoxia on ventilatory limitation during exercise in advanced chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001;163:892–8.
DOI: https://doi.org/10.1164/ajrccm.163.4.2007026
Supporting Agencies
noneHow to Cite
Ora, Josuel, Angelo Coppola, Andrea Perduno, Gian Marco Manzetti, Ermanno Puxeddu, and Paola Rogliani. 2021. “Acute Effect of Oxygen Therapy on Exercise Tolerance and Dyspnea Perception in ILD Patients”. Monaldi Archives for Chest Disease 92 (2). https://doi.org/10.4081/monaldi.2021.1925.
Copyright (c) 2021 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
