Early Effects of Oxygen Administration and Prognosis in Chronic Obstuctive Pulmonary Disease and Cor Pulmonale1–3

Abstract

The purpose of this study was to develop criteria for predicting survival and clinical improvement with long-term domiciliary home oxygen therapy (LTDO₂) in patients with both chronic obstructive pulmonary disease (COPD) and cor pulmonale (CP). Twenty-eight such patients were divided into 2 groups, responders (R) and nonresponders (NR), on the basis of the fall in their mean pulmonary artery pressure ( ) while breathing 28% O₂ for 24 h. The R (n=17) and NR (n=11) had greater than and lesser than 5 mmHg, respectively. Eighty-eight percent of the R, but only 22% of the NR, were alive at the end of 2 yr of LTDO₂. Eighty-five percent of R, but only 11% of NR, achieved an end-exercise maximal oxygen consumption (max ) greater than 6.5 ml min^-1 kg ^-1. Left ventricular ejection fraction improved while breathing O₂ for 48 h in the R only. The NR and R were similar in all other respects. We conclude that greater than 5 mmHg and/or max 6.5 ml min^-1 kg^-1 or greater predict 2-yr survival with LTDO₂ in patients with COPD and CP, and it can be useful in planning their management.