ERJ open research · 2026
Effect of short-term supplemental oxygen therapy on 6-min walk distance in highlanders at risk for pulmonary hypertension: a randomised, crossover trial.
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Hertig Dinah, Furian Michael, Müller Julian, Mayer Laura, Titz Anna, Lichtblau Mona, Häfliger Alina, Reimann Lena, Vella Alessandro, Mademilov Maamed, Omuralieva Adilet, von Grünigen Kay, Schneider Simon R, Sooronbaev Talant, Ulrich Silvia
Аннотация
BACKGROUND: Little is known about the effects of portable supplemental oxygen therapy (SOT) to improve exercise performance in highlanders at risk for high-altitude pulmonary hypertension (HAPH). We aimed to investigate whether SOT improves the 6-min walk distance (6MWD) and reduces perceived dyspnoea in highlanders at risk for HAPH.
METHODS: In a pragmatic randomised open-label crossover trial, adult highlanders, living >2500 m, with a peak tricuspid regurgitation velocity >2.8 m·s-1 corresponding to a tricuspid regurgitation pressure gradient (TRPG) ≥31 mmHg by echocardiography were included. Highlanders were randomised to perform two 6-min walk tests at 3250 m with and without SOT (50 mL pulse volume, via nasal cannula, provided by a portable device). The primary outcome was the effect of SOT on the 6MWD compared with ambient air (air). Secondary outcomes were vital parameters and dyspnoea assessed by the Borg Category-Ratio 10 (CR10) Scale with SOT versus air.
RESULTS: 47 highlanders (44% male, mean±sd age of 52±12 years, TRPG of 41±10 mmHg and oxygen saturation (S pO2 ) of 88±3%) were included. SOT did not improve 6MWD compared with air (457±90 m versus 475±84 m; mean difference with SOT of -18 m (95% CI -30-8; p=0.241)). End-exercise dyspnoea was significantly lower with SOT compared with air, along with reduced heart rate and higher S pO2 .
CONCLUSION: In hypoxaemic highlanders at risk for HAPH, portable low-dose SOT did not improve 6MWD, despite lower dyspnoea perception, lower heart rates and higher S pO2 at end-exercise. This indicates that low-dose SOT oxygen, as commonly applied in various clinical settings, does not increase 6MWD. Whether it reduces cardiovascular stress during exercise needs to be further studied.
METHODS: In a pragmatic randomised open-label crossover trial, adult highlanders, living >2500 m, with a peak tricuspid regurgitation velocity >2.8 m·s-1 corresponding to a tricuspid regurgitation pressure gradient (TRPG) ≥31 mmHg by echocardiography were included. Highlanders were randomised to perform two 6-min walk tests at 3250 m with and without SOT (50 mL pulse volume, via nasal cannula, provided by a portable device). The primary outcome was the effect of SOT on the 6MWD compared with ambient air (air). Secondary outcomes were vital parameters and dyspnoea assessed by the Borg Category-Ratio 10 (CR10) Scale with SOT versus air.
RESULTS: 47 highlanders (44% male, mean±sd age of 52±12 years, TRPG of 41±10 mmHg and oxygen saturation (S pO2 ) of 88±3%) were included. SOT did not improve 6MWD compared with air (457±90 m versus 475±84 m; mean difference with SOT of -18 m (95% CI -30-8; p=0.241)). End-exercise dyspnoea was significantly lower with SOT compared with air, along with reduced heart rate and higher S pO2 .
CONCLUSION: In hypoxaemic highlanders at risk for HAPH, portable low-dose SOT did not improve 6MWD, despite lower dyspnoea perception, lower heart rates and higher S pO2 at end-exercise. This indicates that low-dose SOT oxygen, as commonly applied in various clinical settings, does not increase 6MWD. Whether it reduces cardiovascular stress during exercise needs to be further studied.