Should oxygen be used for patients with chronic heart failure?
Researchers at the University of Hull, in the UK, have just launched a major new trial investigating the effects of home oxygen therapy in patients with chronic heart failure (CHF).
Since home oxygen therapy (HOT) can be inconvenient for patients is and expensive, a robust trial is required to offer some clear guidance about whether HOT should be offered routinely to patients with chronic heart failure.
Around 669,000 people in the UK aged over 45 have the condition, in which the heart is too weak to pump blood efficiently around the body. Chronic heart failure is frequently characterised by breathlessness, which can be worse when the patient lies down to sleep.
Although home oxygen therapy is frequently prescribed to treat the symptoms, there is no conclusive evidence as to its efficacy. Indeed, although the patient may be short of breath, this is not always linked to low blood oxygen levels.
Professor Andrew Clark, of the University of Hull, who leading the study, explains: "There is a strong belief that oxygen must be vital for patients suffering from breathlessness: however we can't be certain that home oxygen therapy is effective, particularly since we know many CHF patients who are well treated with medication have normal levels of arterial oxygen in their blood while they are at rest and during exercise."
The research was commissioned by the National Institute for Health Research Health Technology Assessment (NIHR HTA), which funds research into the effectiveness, costs and broader impacts of healthcare treatments.
Around 165 patients will be recruited to the randomised trial and given either overnight HOT, or HOT for 17 hours per day, alongside their regular medical therapies. A third group will continue to receive their normal medical therapy with no home oxygen. The trial will last for two years, during which time the research team will measure a range of factors, including the patient's overall quality of life, exercise ability and breathlessness, as well as the severity of CHF.
"The results of the research will offer clinicians useful guidance on whether home oxygen therapy is beneficial to patients with chronic heart failure," says Professor Clark. "This will enable them to better target treatments for the benefit of patients and to ensure resources are used cost-effectively."
The study will be based initially at Hull, but involving other research institutions around the UK as the study progresses.