Chest
Clinical InvestigationsEffects of Long-term Oxygen Therapy on Pulmonary Hemodynamics in COPD Patients: A 6-Year Prospective Study
Section snippets
Materials and Methods
Ninety-five consecutive COPD patients, 72 male and 23 female, who were qualified for LTOT between 1986 and 1991, participated in the study. The diagnosis of COPD was based on generally accepted criteria.15 Qualification criteria for LTOT were described elsewhere.16 Briefly, to qualify, patients had to present with stable hypoxemia (PaO2<55 mm Hg) assessed in the steady-state period of the disease. Also patients with moderate hypoxemia (PaO2=56 to 65 mm Hg) were accepted for LTOT if signs of
Results
From 95 enrolled patients, 73 survived 2 years. Thirty-nine subjects agreed to be catheterized again. On average, they had been using oxygen for 14.7 h/d. Results of the initial and the second catheterization are shown in Table 3. There were no significant changes in the studied variables.
Thirty-one patients completed 4 years of LTOT. Twenty-one agreed to have the third pulmonary catheterization. The average oxygen use in that group was 13.5 h/d. The results of all three catheterizations
Discussion
To our knowledge, this is the longest prospective study describing effects of breathing supplemental oxygen on pulmonary hemodynamics in patients with severe COPD, complicated by hypoxic PH. The results of our investigation are strengthened by intermediate data taken at regular intervals. The study has clearly shown that LTOT administered for approximately 14 h/d induced a small reduction of PH during the first 2 years of LTOT. Thereafter, PH returned to the initial level and showed
References (35)
- et al.
First pass radionuclide assessment of right and left ventricular ejection fraction in chronic pulmonary disease: effect of oxygen upon exercise response
Chest
(1980) - et al.
Pulmonary hypertension and right ventricular function in patients with COPD
Chest
(1988) - et al.
The effect of continued hypoxia on rat pulmonary arterial circulation: an ultrastructural study
Lab Invest
(1978) - et al.
Hypertensive pulmonary vascular disease in states of chronic hypoxia
J Pathol
(1968) - et al.
Clinical types of chronic obstructive lung diseases in London and Chicago
Am Rev Respir Dis
(1964) - et al.
Prognostic value of pulmonary artery pressure in chronic obstructive pulmonary disease
Thorax
(1981) - et al.
Physiological variables and mortality in patients with various categories of chronic respiratory disease
Bull Eur Physiopathol Respir
(1984) - et al.
The role of long-term continuous oxygen administration in patients with chronic airway obstruction with hypoxemia
Ann Intern Med
(1967) - et al.
Reversal of pulmonary hypertension by prolonged oxygen administration to patients with chronic bronchitis
Circ Res
(1969) - et al.
Daily requirement of oxygen to reverse pulmonary hypertension in patients with chronic bronchitis
BMJ
(1972)
Effects of prolonged oxygen therapy on pulmonary hypertension and blood viscosity in patients with advanced cor pulmonale
Respiration
Long-term domiciliary oxygen in chronic bronchitis with pulmonary hypertension
BMJ
Twelve year clinical study of patients with hypoxic cor pulmonale given long-term domiciliary oxygen therapy
Thorax
Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema
Lancet
Hemodynamic response to oxygen therapy in chronic obstructive pulmonary disease
Ann Intern Med
Long-term oxygen therapy can reverse the progression of pulmonary hypertension in patients with chronic obstructive pulmonary disease
Am Rev Respir Dis
Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease
Am J Respir Crit Care Med
Cited by (179)
Oxygen Therapy in Sleep-Disordered Breathing
2021, ChestPulmonary Hypertension Related to Chronic Obstructive Pulmonary Disease and Diffuse Parenchymal Lung Disease: A Focus on Right Ventricular (Dys)Function
2018, Heart Failure ClinicsCitation Excerpt :Prior studies have postulated that hypoxic vasoconstriction and chronic inflammation lead to increased tone and muscularization of small pulmonary arteries resulting in epithelial damage, small vessel destruction, and fibrosis. This vascular remodeling likely explains why there is only a partial reversal of the pulmonary vascular resistance in response to oxygen.6 In addition, the loss of pulmonary vascular surface (ie, lung destruction) can serve as an additive increase in pulmonary vascular resistance.
Oxygen Therapy in COPD
2023, Respiratory Care