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Effects of hyperoxia on dyspnoea and exercise endurance in fibrotic interstitial lung disease

Michele R. Schaeffer, Christopher J. Ryerson, Andrew H. Ramsook, Yannick Molgat-Seon, Sabrina S. Wilkie, Satvir S. Dhillon, Reid A. Mitchell, A. William Sheel, Nasreen Khalil, Pat G. Camp, Jordan A. Guenette
European Respiratory Journal 2017 49: 1602494; DOI: 10.1183/13993003.02494-2016
Michele R. Schaeffer
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, BC, CanadaDept of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
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Christopher J. Ryerson
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, BC, CanadaDept of Medicine, University of British Columbia, Vancouver, BC, Canada
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Andrew H. Ramsook
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, BC, CanadaDept of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
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Yannick Molgat-Seon
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, BC, CanadaSchool of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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Sabrina S. Wilkie
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada
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Satvir S. Dhillon
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada
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Reid A. Mitchell
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, BC, CanadaDept of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
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A. William Sheel
School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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Nasreen Khalil
Dept of Medicine, University of British Columbia, Vancouver, BC, Canada
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Pat G. Camp
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, BC, CanadaDept of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
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Jordan A. Guenette
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, BC, CanadaDept of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
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  • For correspondence: jordan.guenette@hli.ubc.ca
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Extract

Dyspnoea is a major source of distress and is the hallmark symptom of patients with interstitial lung disease (ILD). Supplemental oxygen may alleviate dyspnoea by attenuating arterial oxygen desaturation, increasing oxygen delivery and reducing the drive to breathe; however, previous studies show conflicting results on the effectiveness of supplemental oxygen on dyspnoea and exercise performance in ILD [1–6]. Methodological factors in these studies likely led to underestimation of the potential magnitude of improvement, including an insufficient fraction of inspired oxygen (FIO2) and/or the use of self-paced walking tests and incremental cycle tests rather than constant-load exercise protocols [3–8]. Dyspnoea was also either not evaluated or only evaluated at peak exercise [1, 3–6], which is insensitive to change compared to more clinically relevant submaximal exercise [8]. Finally, some studies were retrospective and did not include a blinded room-air exercise trial, making it difficult to rule out the potential placebo effect [4, 5]. The purpose of this study was to determine the effects of hyperoxia on exercise endurance as well as the intensity and qualitative dimensions of exertional dyspnoea in patients with fibrotic ILD.

Abstract

Hyperoxia significantly improves exertional dyspnoea and exercise tolerance in patients with fibrotic ILD http://ow.ly/WbHf309VwcM

Acknowledgements

Author contributions: All authors played a role in the content and writing of the manuscript. J.A. Guenette was the principal investigator and contributed the original idea for the study; M.R. Schaeffer, C.J. Ryerson, A.W. Sheel, N. Khalil, P.G. Camp and J.A. Guenette had input into the study design and conduct of the study; M.R. Schaeffer, C.J. Ryerson, A.H. Ramsook, Y. Molgat-Seon, S.S. Wilkie, R.A. Mitchell and S.S. Dhillon collected the data; and M.R. Schaeffer, C.J. Ryerson, A.H. Ramsook, S.S. Dhillon, R.A. Mitchell and J.A. Guenette performed data analysis.

Footnotes

  • This study is registered at ClinicalTrials.gov with identifier NCT01781793

  • Support statement: This study was funded by the British Columbia Lung Association (BCLA), an Emerging Research Leaders Initiative Grant from the Canadian Respiratory Research Network, and seed funding from the Dept of Physical Therapy at the University of British Columbia. M.R. Schaeffer was supported by fellowships from the University of British Columbia and BCLA. C.J. Ryerson and P.G. Camp were supported by Scholar Awards from the Michael Smith Foundation for Health Research (MSFHR). Y. Molgat-Seon was supported by a fellowship from the University of British Columbia and a postgraduate scholarship from the Natural Sciences and Engineering Research Council of Canada. J.A. Guenette was supported by a Scholar Award from the MSFHR and a New Investigator Award from the Providence Health Care Research Institute and St. Paul's Hospital Foundation. The funders had no role in the study design, data collection and analysis, or preparation of the manuscript. Funding information for this article has been deposited with the Crossref Funder Registry.

  • Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com

  • Received October 17, 2016.
  • Accepted February 11, 2017.
  • Copyright ©ERS 2017
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Effects of hyperoxia on dyspnoea and exercise endurance in fibrotic interstitial lung disease
Michele R. Schaeffer, Christopher J. Ryerson, Andrew H. Ramsook, Yannick Molgat-Seon, Sabrina S. Wilkie, Satvir S. Dhillon, Reid A. Mitchell, A. William Sheel, Nasreen Khalil, Pat G. Camp, Jordan A. Guenette
European Respiratory Journal May 2017, 49 (5) 1602494; DOI: 10.1183/13993003.02494-2016

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Effects of hyperoxia on dyspnoea and exercise endurance in fibrotic interstitial lung disease
Michele R. Schaeffer, Christopher J. Ryerson, Andrew H. Ramsook, Yannick Molgat-Seon, Sabrina S. Wilkie, Satvir S. Dhillon, Reid A. Mitchell, A. William Sheel, Nasreen Khalil, Pat G. Camp, Jordan A. Guenette
European Respiratory Journal May 2017, 49 (5) 1602494; DOI: 10.1183/13993003.02494-2016
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