Pulmonary Hemodynamics and Home Oxygen Therapy in Patients with Chronic Respiratory Failure.

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  • Kubo Susumu
    Department of Medicine, National Sanatorium Nagasaki Hospital
  • Yasuoka Akira
    Department of Medicine, National Sanatorium Nagasaki Hospital
  • Rikitake Teruhiko
    Department of Medicine, National Sanatorium Nagasaki Hospital
  • Shimoda Terufumi
    Department of Medicine, National Sanatorium Nagasaki Hospital
  • Fujita Kiyo
    Department of Medicine, National Sanatorium Nagasaki Hospital
  • Nakatomi Masao
    Department of Medicine, National Sanatorium Nagasaki Hospital
  • Hara Kohei
    The Second Department of Medicine, School of Medicine, Nagasaki University

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  • 慢性呼吸不全の肺循環動態と在宅酸素療法

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Abstract

The authors examined pulmonary hemodynamics with respect to underlying diseases, severity and type of chronic respiratory failure, and the incidence and effect of home oxygen therapy (HOT) in 155 patients with chronic lung diseases (old pulmonary tuberculosis (OTB) 45, chronic pulmonary emphysema (CPE) 54, chronic bronchitis (CBR) 42 and fibrosing lung disease (FLD) 14). They underwent right heart catheterization during a stable period, while breathing room air. The arterial PO2 ranged from 64.3±9.7 Torr (CBR) to 69.9±10.0 Torr (CPE), and the mean pulmonary arterial pressure ranged from 17.3±4.6mmHg (CPE) to 20.6±5.4mmHg (OTB). The incidence of pulmonary hypertension (PH, PA mean≥20mmHg) was53.3% in OTB, 40% in CBR, 35.7% in FLD, 23.8% in CPE, 69% in respiratory failure, 40% in quasi-respiratory failure, and 2.1% in non-respiratory failure. The percentage of patients who recieved HOT was 84.5% in respiratory failure and 54.1% in quasi-respiratory failure. Comparing Type I with Type II chronic respiratory failure, the incidence of PH was lower in the former than the latter (38.3% vs 80.6%), whereas HOT was applied to an equal percentage of patients (67.4%) in both groups. The effect of HOT was evaluated in 11 patients with chronic respiratory failure. The mean pulmonary arterial pressure was 22.7±4.7mmHg before HOT, and decreased to 20.7±5.6mmHg after 24.5±10.1 months of HOT. Although this difference was not significant statistically, this result suggests the desirable effect of HOT on pulmonary hemodynamics.

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