BLOOD-VOLUME AND ARTERIAL BLOOD-GASES IN PATIENTS WITH CHRONIC OBSTRUCTIVE LUNG-DISEASE DURING AND AFTER ACUTE RESPIRATORY-FAILURE

  • 1 January 1979
    • journal article
    • research article
    • Vol. 60  (1) , 6-16
Abstract
The blood volume and arterial blood gases of 18 patients with chronic obstructive lung disease were studied over a period of 1/2-5 yr, including 35 acute exacerbations of the lung disease. Treatment during exacerbation was directed at infection, bronchial obstruction and hypervolemia. Long-term diuretic therapy was instituted during the follow-up period. On admission all patients suffered from severe dyspnea, all but 2 had signs of peripheral edema and/or liver congestion and 1/3 had increased jugular venous pressure. Blood volume was increased in all patients and 8 of them had a hematocrit above 50%. PaO2 [arterial O2 tension] was severely reduced and PaCO2 increased on admission. At discharge, these symptoms and signs diminished or disappeared. Blood volume fell an average of 1 l and a further reduction of 0.41 was noticed during the follow-up period. Blood gases improved by discharge and a further improvement accompanied the reduction of blood volume during the follow-up period. Hypervolemia is apparently common in patients with advanced chronic obstructive lung disease and may impair arterial oxygenation. Long term diuretic therapy is necessary for maintaining a normal blood volume.

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