title: Hemodynamic effects of supplemental oxygen administration in congestive heart failure.
abstract: OBJECTIVE
  This study sought to determine the hemodynamic effects of oxygen therapy in heart failure.
  
  
  BACKGROUND
  High dose oxygen has detrimental hemodynamic effects in normal subjects, yet oxygen is a common therapy for heart failure. Whether oxygen alters hemodynamic variables in heart failure is unknown.
  
  
  METHODS
  We studied 10 patients with New York Heart Association functional class III and IV congestive heart failure who inhaled room air and 100% oxygen for 20 min. Variables measured included cardiac output, stroke volume, pulmonary capillary wedge pressure, systemic and pulmonary vascular resistance, mean arterial pressure and heart rate. Graded oxygen concentrations were also studied (room air, 24%, 40% and 100% oxygen, respectively; n = 7). In five separate patients, muscle sympathetic nerve activity and ventilation were measured during 100% oxygen.
  
  
  RESULTS
  The 100% oxygen reduced cardiac output (from 3.7 +/- 0.3 to 3.1 +/- 0.4 liters/min [mean +/- SE], p < 0.01) and stroke volume (from 46 +/- 4 to 38 +/- 5 ml/beat per min, p < 0.01) and increased pulmonary capillary wedge pressure (from 25 +/- 2 to 29 +/- 3 mm Hg, p < 0.05) and systemic vascular resistance (from 1,628 +/- 154 to 2,203 +/- 199 dynes.s/cm5, p < 0.01). Graded oxygen led to a progressive decline in cardiac output (one-way analysis of variance, p < 0.0001) and stroke volume (p < 0.017) and an increase in systemic vascular resistance (p < 0.005). The 100% oxygen did not alter sympathetic activity or ventilation.
  
  
  CONCLUSIONS
  In heart failure, oxygen has a detrimental effect on cardiac output, stroke volume, pulmonary capillary wedge pressure and systemic vascular resistance. These changes are independent of sympathetic activity and ventilation.
authors.affiliation: Division of Cardiology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, Pennsylvania, USA.
authors.forename: W A
authors.initials: WA
authors.lastname: Haque
authors.forename: J
authors.initials: J
authors.lastname: Boehmer
authors.forename: B S
authors.initials: BS
authors.lastname: Clemson
authors.forename: U A
authors.initials: UA
authors.lastname: Leuenberger
authors.forename: D H
authors.initials: DH
authors.lastname: Silber
authors.forename: L I
authors.initials: LI
authors.lastname: Sinoway
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects; D011659:Pulmonary Gas Exchange; D013564:Sympathetic Nervous System / Q000502:physiology; D013997:Time Factors
chemical_list: D010100:Oxygen