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Lung

, Volume 168, Supplement 1, pp 762–769 | Cite as

Survival in chronic obstructive pulmonary disease after diagnosis of pulmonary hypertension related to long-term oxygen therapy

  • G. Wuertemberger
  • J. Zielinsky
  • P. Sliwinsky
  • C. Auw-Haedrich
  • H. Matthys
Long-Term Oxygen Therapy

Abstract

Long-term oxygen therapy has proven increased survival rates of patients with severe chronic obstructive pulmonary lung disease and remains the only treatment so far to prolong life in these patients. No study has related hemodynamic measurements, lung function data, and age at beginning of long-term oxygen treatment to prognosis in these patients. In a retrospective study, we analyzed these parameters for 76 survivors and 51 deceased, starting supplemental oxygen therapy in 1981 and thereafter, concerning significant differences using the Proportional Hazards General Linear Model Procedure. A longer survival could be shown for PaP<30mmHg when compared to PaP>30mmHg (p=0.0442) and for the age <60 yrs compared to >60 yrs (p=0.0317). No contribution to prognosis could be made by FEV1, IVC, PaO2 and nationality. We conclude that hemodynamic measurements prior to long-term oxygen treatment are necessary since, besides age, they serve as the only indicator for prognosis in these patients.

Key words

Chronic obstructive pulmonary disease Long-term oxygen treatment Pulmonary hemodynamics Lung function Survival 

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References

  1. 1.
    Abraham AS, Cole RB, Green ID, Headworth-Whitty RB, Clarke SW, Bishop JM (1969) Factors contributing to the reversible pulmonary hypertension of patients with acute respiratory failure studied by serial observations during recovery. Circulation Res 24:51–60PubMedGoogle Scholar
  2. 2.
    Fishman AP (1976) Chronic cor pulmonale. Am Rev Respir Dis 114:775–794PubMedGoogle Scholar
  3. 3.
    Report of the Medical Research Council Working Party (1981) Long-term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Lancet 1:681–685Google Scholar
  4. 4.
    Nocturnal Oxygen Therapy Trial Group (1980) Continuous or nocturnal oxygen therapy in hypoxic chronic obstructive lung disease. Ann Intern Med 93:391–398Google Scholar
  5. 5.
    Timms RM, Khaja FU, Williams GW, Nocturnal Oxygen Therapy Trial Group (1985) Hemodynamic response to oxygen therapy in chronic obstrictive pulmonary disease. Ann Int Med 102:29–36PubMedGoogle Scholar
  6. 6.
    Ashutosh K, Mead G, Dunsky M (1983) Early effects of oxygen administration and prognosis in chronic obstructive pulmonary disease and cor pulmonale. Am Rev Respir Dis 127:399–404PubMedGoogle Scholar
  7. 7.
    Boushy SF, Thompson HK Jr, North LB, Beale AR, Snow TR (1973) Prognosis in chronic obstructive pulmonary disease. Am Rev Respir Dis 108:1373–1383PubMedGoogle Scholar
  8. 8.
    Postma DS, Burema J, Gimeno F, May JF, Smit JM, Steenhuis EJ, VD Veele LTH, Sluiter HJ (1979) Prognosis in severe chronic obstructive pulmonary disease. Am Rev Respir Dis 119:357–366PubMedGoogle Scholar
  9. 9.
    Traver GA, Cline MG, Burrows B (1979) Predictors of mortality in chronic obstructive pulmonary disease. A 15-year follow-up study. Am Rev Respir Dis 119:895–902PubMedGoogle Scholar
  10. 10.
    Hislop A, Reid L (1976) New findings in pulmonary arteries of rats with hypoxia-induced pulmonary hypertension. British Journal of Experimental Pathology 57:542PubMedGoogle Scholar
  11. 11.
    Meyrick B, Reid L (1978) The effect of continued hypoxia on rat pulmonary arterial circulation. An ultrastructural study. Laboratory Investigation 38:188PubMedGoogle Scholar
  12. 12.
    Qurednik A, Susa Z (1975) How long does the pulmonary hypertension last in chronic obstructive bronchopulmonary disease? In: Widimsky J ed. Progress in respiratory research. Vol. 9: Pulmonary hypertension. Basel: Karger, p 24–28Google Scholar
  13. 13.
    Weitzenblum E, Sautegeau A, Ehrhart M, Mammosser M, Hirth C, Roegel E (1984) Long-term course of pulmonary arterial pressure in chronic obstructive pulmonary disease. Am Rev Respir Dis 130:993–998PubMedGoogle Scholar
  14. 14.
    Ashutosh K, Dunsky M (1987) Non-invasive tests for responsiveness of pulmonary hypertension to oxygen. Chest 92:393–399PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1990

Authors and Affiliations

  • G. Wuertemberger
    • 1
  • J. Zielinsky
    • 2
  • P. Sliwinsky
    • 2
  • C. Auw-Haedrich
    • 1
  • H. Matthys
    • 1
  1. 1.Division of Pneumology, Department of Internal MedicineUniversity HospitalFreiburgFRG
  2. 2.Department of Respiratory MedicineInstitute of Tuberculosis and Lung DiseasesWarsawPoland

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