PROGNOSIS OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AFTER HOSPITALIZATION FOR ACUTE VENTILATORY FAILURE - A 3-YEAR FOLLOW-UP STUDY

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Abstract
This study represents an analysis of data concerning 43 patients with chronic obstructive pulmonary disease who survived an admission to the hospital for acute ventilatory failure during 1960 and 1961. Only 23 (54%) were alive 3 years later; there was no difference in the pulmonary function studies between the survivors and nonsurvivors. A group of patients with chronic obstructive pulmonary disease, who suffered a comparable degree of disability, but who had never been in acute ventilatory failure, was compared with these 43 patients. The control group had a lower arterial PCO2 higher arterial O2 saturation, and lower resting O2 consumption than the study group. In as much as the minute ventilation and alveolar ventilation were essentially the same in these 2 groups, it was concluded that increased work of breathing was largely responsible for the increased metabolic rate and the blood gas abnormalities; however, the lower O2 saturation in the study group was accentuated by nonuniformity of ventilation-perfusion relationships. Although there is some evidence that relatively normal steady-state diffusion capacity and arterial blood gas content are associated with a favorable prognosis in patients with chronic obstructive pulmonary disease, death in this condition is largely due to acute ventilatory failure that cannot be anticipated from the knowledge of pulmonary function.