title: Blood volume and arterial blood gases in patients with chronic obstructive lung disease during and after acute respiratory failure.
abstract: The blood volume and arterial blood gases of 18 patients with chronic obstructive lung disease were studied over a period of 1/2 to 5 years, 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 dyspnoea, all but two had signs of peripheral oedema and/or liver congestion and one-third had increased jugular venous pressure. Blood volume was increased in all patients and eight of them had a hematocrit above 50%. PaCO2 was severely reduced and PaCO2  increased on admission. At discharge, these symptoms and signs had all diminished or disappeared. Blood volume had fallen an average of 11 and a further reduction of 0.41 was noticed during the follow-up period. Blood gases had improved by discharge and a further improvement accompanied the reduction of blood volume during the follow-up period. It is suggested that 1) hypervolemia is common in patients with advanced chronic obstructive lung disease; 2) hypervolemia may impair arterial oxygenation; 3) long-term diuretic therapy seems to be necessary for maintaining a normal blood volume.
mesh_terms: D000328:Adult; D000368:Aged; D001810:Blood Volume; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002245:Carbon Dioxide / Q000097:blood*; D004232:Diuretics / Q000627:therapeutic use; D004417:Dyspnea / Q000503:physiopathology; D005260:Female; D006400:Hematocrit; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D010102:Oxygen Inhalation Therapy; D010313:Partial Pressure; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000503:physiopathology*; D014140:Tracheotomy
chemical_list: D001993:Bronchodilator Agents; D004232:Diuretics; D002245:Carbon Dioxide; D010100:Oxygen