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Oxygen supplementation before or after submaximal exercise in patients with chronic obstructive pulmonary disease
  1. K Nandi1,
  2. A A Smith1,
  3. A Crawford2,
  4. K D MacRae3,*,
  5. R Garrod2,
  6. W A Seed1,
  7. C M Roberts2
  1. 1Department of Respiratory Medicine, Charing Cross Hospital, London W6 8RF, UK
  2. 2Chest Unit, Whipps Cross University Hospital, Leytonstone, London E11 1NR, UK
  3. 3Postgraduate Medical School, University of Surrey, Guildford GU2 5XH, UK
  1. Correspondence to:
    Dr C M Roberts, Chest Unit, Whipps Cross University Hospital, London E11 1NR, UK;


Background: Evidence for improved exercise tolerance or relief of breathlessness by short term use of oxygen before or after exercise in patients with chronic obstructive pulmonary disease (COPD) is scant, and guidelines for this treatment are lacking despite widespread provision in the UK.

Methods: The effect of oxygenation either before or after exercise on perception of breathlessness and walk distance was studied in a group of patients with moderate to severe COPD (mean forced expiratory volume in 1 second (FEV1) 34% of predicted, mean 6 minute walk distance on air 283 m), all of whom desaturated by at least 4% on submaximal exercise. Oxygen (28%) or air was delivered double blind and in random order, either for 5 minutes before a standard 6 minute walk test (n=34) or for 5 minutes following the end of the test (n=18). Exercise tolerance was measured as the distance achieved and breathlessness was assessed using visual analogue scales (VAS) which were scored before and after exercise and during recovery.

Results: No increase in mean walk distance after oxygen (288 v 283 m) and no improvement in mean breathlessness scores (58 v 54 mm) or recovery times occurred with oxygen taken either before (177 v 184 seconds) or after exercise (182 v 151 seconds).

Conclusions: This group of patients with COPD derived no physiological or symptomatic benefit from oxygen breathed for short periods before or after submaximal exercise. Domiciliary oxygen should only be prescribed for such patients if they have shown objective evidence of benefit on exercise testing.

  • domiciliary oxygen
  • breathlessness
  • chronic obstructive pulmonary disease

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  • * Dr MacRae died during the final preparation of the manuscript.

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