15 hours of oxygen therapy per day is enough | University of Gothenburg

Patients with severe oxygen deficiency do not need around-the-clock long-term oxygen therapy. A new study, conducted in part by researchers at the University of Gothenburg, shows that 15 hours of oxygen therapy per day is sufficient to reduce the risk of hospitalization or death within one year.

The results are published by the journal *New England Journal of Medicine*. The study provides important information that could improve the quality of life for patients without compromising their health.

Anders Andersson, adjunct senior lecturer at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at the University of Gothenburg, highlights the importance of collaboration for the study's success:

“We are a number of oxygen clinics across the country that participated. Collaboration is the key to success, both now in this current study and in the future. The fact that we in Gothenburg gained a prominent position in the publication is due to us having included the second-largest number of patients in the study. This shows that we can conduct high-quality studies here at Sahlgrenska University Hospital and Sahlgrenska Academy that become very significant,” says Anders Andersson, who worked together with chief physician Savvas Papadopoulos at the pulmonary clinic in Gothenburg.

Long-term oxygen therapy has long been a standard treatment for patients with severe hypoxemia, a condition where the body does not receive enough oxygen. Previous studies have shown that oxygen therapy for at least 15 hours a day can extend the lifespan of these patients. However, there have been no studies comparing 15 hours of oxygen therapy per day with 24 hours per day. Therefore, the recommendation has been to use oxygen for at least 15 hours a day but as much as possible, even though it can be a heavy burden for patients to remain on oxygen therapy.

The current study aimed to test the hypothesis that 24 hours of oxygen therapy per day does not provide better outcomes than therapy for 15 hours per day. The study included patients who had recently started oxygen therapy for chronic, severe resting hypoxemia, and they were followed for one year to examine any differences in the risk of hospitalization or death.

Between May 2018 and April 2022, a total of 241 patients participated in the study. They were randomly assigned to receive either 24 hours of oxygen therapy per day (117 patients) or 15 hours per day (124 patients).

The study showed that the risk of hospitalization or death within a year was almost identical between the groups. In the group receiving 24 hours of oxygen per day, 124.7 events per 100 person-years were noted, compared to 124.5 events in the group receiving therapy for 15 hours per day. The researchers found no significant difference between the groups in terms of hospitalizations, deaths, or side effects, indicating that longer oxygen therapy does not provide any additional benefit.

Anders Andersson also emphasizes that the study could never have been completed without the work done by the oxygen nurses throughout the process.

“This study could never have happened and never reached its goal if we didn't have our fantastic oxygen nurses, especially Eva Moreno-Johansson,” he says.

The study was conducted in collaboration between several hospitals and academic institutions in the country, initiated by Associate Professor Josefin Sundh, a physician in Örebro, and Associate Professor Magnus Ekström, a physician in Karlskrona.