Saudi Cultural Missions Theses & Dissertations
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Item Restricted THE EFFECT OF AMBULATORY OXYGEN THERAPY IN FIBROTIC INTERSTITIAL LUNG DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS(Saudi Digital Library, 2025) Saaty, Layan Fahad; Walters, GarethBackground: Ambulatory oxygen is a supportive therapy often administered during physical activity to alleviate exertional hypoxaemia. Its role in fILD remains uncertain. This review aims to evaluate its effects on symptoms and overall health outcomes. Methods: Eligible RCTs evaluating AOT in adult fILD patients experiencing exertional desaturation. Databases (MEDLINE, Ovid Embase, PubMed, and Google Scholar) were searched to June 2025. Two reviewers independently screened, extracted data, and assessed risk of bias using the Cochrane RoB2 tool. Data were synthesised using random-effects meta-analysis where appropriate. Other outcomes were summarised narratively using the SWiM framework. Results: Ten studies (n = 288) were included. Meta-analysis showed significant improvements in dyspnoea (SMD = –0.31, 95% CI –0.53 to –0.10; p = 0.01), endurance time (MD = 115.01 s, 95% CI 17.30 to 212.71; p = 0.04), and fatigue (SMD = –0.22, 95% CI –0.40 to –0.04; p = 0.03) with AOT compared to placebo. No significant effect was observed for 6MWD (MD = 11.91 m, 95% CI –21.75 to 45.56; p = 0.27), HRQoL (MD = –3.04, 95% CI –13.58 to 7.50; p = 0.17), or peak V̇O2 (SMD = 0.86, 95% CI –3.80 to 5.53; p = 0.26). Narrative synthesis showed improvements in dyspnoea but variable effects on fatigue and psychological outcomes. Most studies were small (7 up to 76 participants), short-term, and laboratory-based, with some concerns regarding the RoB. Discussion: The administration of AOT has alleviated dyspnoea and prolonged endurance time. However, the lack of benefits in HRQoL, walking distance, or peak V̇O2 indicates that short-term relief may not result in significant improvements in these domains. The certainty of the evidence is limited by small sample sizes, brief follow-up periods, heterogeneity in study design and oxygen delivery, and some concerns regarding risk of bias. Conclusion: AOT offers short-term symptomatic benefits in fILD. However, further clinical trials are required to confirm long-term clinical benefits and implement future guidelines.27 0