Noninvasive Tests for Responsiveness of Pulmonary Hypertension to Oxygen

Kumar, Ashutosh; Dunsky, Milton H.

doi:10.1378/chest.92.3.393

Cited by 43 publications

(8 citation statements)

References 22 publications

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“…The effects of LTOT on pulmonary he modynamics and overall survival were similar for the two groups of patients, although the MRC patients received an average of 3 h/day more supplemental oxygen. This hypothesis is also supported by the find ings of Ashutosh et al [9] and Ashutosh and Dunsky [10] who could predict responders and nonresponders to LTOT by repeating hemodynamic measurements in patients breathing oxygen for 24 h at an F i02 of 28%. Patients with a decrease in the mean PAP of 5 mm Hg and more had a significantly better survival over the following 3 years than patients who showed less of a response to this short-term oxygen treatment.…”

Section: Controlled Clinical Studies: Mechanism Of Actionmentioning

confidence: 57%

Long-Term Oxygen Therapy for Cor Pulmonale in Patients with Chronic Obstructive Pulmonary Disease

Solèr

Michel²,

Perruchoud³

1991

Respiration

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Besides smoking cessation, antiobstructive therapy, and the treatment of intercurrent infections, long-term oxygen therapy has had the most impressive impact on survival in patients with chronic obstructive pulmonary disease (COPD). COPD leads to a functional and anatomical obstruction of the pulmonary vascular bed, with the development of pulmonary arterial hypertension and cor pulmonale. In these patients, survival benefit from long-term oxygen therapy (LTOT) stems mainly from improved hemodynamics. However, this improvement is limited: hypoxemic COPD patients treated by LTOT have the same life expectancy as nonhypoxemic COPD patients. Practical aspects concerning the prescription and application of LTOT are discussed, with special emphasis on ambulatory oxygen and oxygen-saving techniques

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Section: Controlled Clinical Studies: Mechanism Of Actionmentioning

confidence: 57%

Long-Term Oxygen Therapy for Cor Pulmonale in Patients with Chronic Obstructive Pulmonary Disease

Solèr

Michel²,

Perruchoud³

1991

Respiration

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“…In 1992 Ashutosh and Dunsky [2] measured pulmonary hypertension in 43 patients with COPD commencing LTOT. A fall in MPAP of more than 5 mmHg was associated with a 3-year mortality of 30% compared with 90% in nonresponders.…”

Section: Discussionmentioning

confidence: 99%

Non-Invasive Estimation of Pulmonary Arterial Hypertension in Chronic Obstructive Pulmonary Disease

Spiropoulos

Charokopos

Petsas

et al. 1999

Lung

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The feasibility and reliability of the combination of several noninvasive methods using a multivariate method of analysis to predict pulmonary artery hypertension (PAH) is evaluated in 20 patients with chronic obstructive pulmonary disease. These methods comprised arterial blood gases (Pao2, Paco2), pulmonary functional parameters (FEV1), echo-Doppler parameters (tricuspid regurgitation jets, acceleration time on pulmonary valve), computed tomography measurements (transhilar distance, hilar thoracic index, and measurement of the descending branch of the right pulmonary artery to the lower lobe). A multiple stepwise regression analysis (including one Doppler parameter, two parameters of arterial blood gases, and one functional parameter) revealed a coefficient of determination (R2) equal to 0.954 for mean pulmonary artery pressure (MPAP) with a standard error of estimate (S.E.E.) of 5.25 mmHg. A stepwise regression analysis including computed tomography and radiographic parameters revealed an R2 equal to 0.970 for PAP with a S.E.E. of 4.26 mmHg. Logistical regression analysis classified correctly 80% of patients with PAH using noninvasive methods such as the diameter of the main pulmonary artery and the diameter of the left pulmonary arterial branch calculated by computed tomography. Not only the presence of PAH but also the level of MPAP can be estimated by the combination of multiple stepwise and logistical regression analyses.

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“…DOUGLAS [18] supports the notion that clinical polysomnography in COPD patients should be carried out only "when [sleep apnoea/hypopnoea syndrome] SAHS is suspected, because of symptoms, or the development of hypoxaemic complications such as cor pulmonale and polycythaemia in patients whose daytime arterial oxygen tension is greater than 60 mmHg". Pulmonary hypertension can be reversible in the acute situation by supplementing oxygen, as was shown by ASHUTOSH and DUNSKY [25]. In a group of 43 COPD patients, they found that 28 had a PAP lowered by~10 mmHg, when breathing 28% oxygen.…”

mentioning

confidence: 81%

Supplemental oxygen for COPD patients with nocturnal desaturations?

Folgering¹

1999

Eur Respir J

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Noninvasive Tests for Responsiveness of Pulmonary Hypertension to Oxygen

Cited by 43 publications

References 22 publications

Long-Term Oxygen Therapy for Cor Pulmonale in Patients with Chronic Obstructive Pulmonary Disease

Long-Term Oxygen Therapy for Cor Pulmonale in Patients with Chronic Obstructive Pulmonary Disease

Non-Invasive Estimation of Pulmonary Arterial Hypertension in Chronic Obstructive Pulmonary Disease

Supplemental oxygen for COPD patients with nocturnal desaturations?

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