Should patients have right heart catheterization prior to long-term oxygen treatment?
The presence of pulmonary hypertension (PH) is not an obligatory prerequisite for prescribing long-term oxygen therapy (LTO) in patients with chronic obstructive pulmonary disease (COPD), at least when PaO2 is repeatedly less than 55 mmHg in a stable state of the disease. It is generally accepted that LTO is indicated in patients whose PaO2 is in the range 55-59 mmHg, but exhibiting polycythaemia, "cor pulmonale", and (or) PH. The clinical signs of "cor pulmonale" occur late and the noninvasive diagnosis of PH is not yet satisfactory; it ensues that right heart catheterization is useful in these patients, before prescribing LTO. Pulmonary hypertension is probably the most important consequence of long-standing hypoxaemia and, in our opinion, the presence and the degree of PH should be assessed in every patient before starting such a heavy therapy as LTO.
Weitzenblum
E
E
Pulmonary Function Laboratory, University Hospital, Strasbourg, France.
Apprill
M
M
Ehrhart
M
M
Oswald
M
M
D006328:Cardiac Catheterization; D005541:Forced Expiratory Volume; D006801:Humans; D006976:Hypertension, Pulmonary / Q000628:therapy*; D008134:Long-Term Care; D008173:Lung Diseases, Obstructive / Q000628:therapy*; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D011660:Pulmonary Heart Disease / Q000628:therapy
D010100:Oxygen