[Physiopathology, diagnosis and treatment of severe chronic hypoxemia. Role of residential chronic oxygen therapy].
The purpose of this article is to review the etiological and pathophysiological aspects of chronic severe hypoxemia (CSH) and to determine the indications of long-term oxygen therapy (LTOT). Three hypothesis are presented and analyzed: 1) CSH is harmful to the economy; 2) LTOT is therefore useful; 3) LTOT is not toxic and does not imply major risks than the benefits that it offers. Changes are produced by prolonged exposure to low levels of O2 leading to a sustained increase in pulmonary artery pressure. Secondary pulmonary hypertension (SPH) due to chronic hypoxemia is much more subtle and less symptomatic than that produced by other pathologies. Chronic obstructive pulmonary disease is the most common cause of CSH; these patients have a poor prognosis associated to the hypoxemia and its effects, being a PaO2 below 60 mmHg one of the most precise factors of mortality. Patients selection criteria for LTOT different sources for home oxygen therapy, methods of administration and finally an update of LTOT situation in our country and abroad are discussed.
Cáneva
J O
JO
Sección Neumonología, Instituto de Cardiología y Cirugía Cardiovascular, Fundación Favaloro, Av Belgrano 1746, 1093 Buenos Aires, Argentina. jcaneva@ffavaloro.org
Rabec
C A
CA
De Salvo
M C
MC
Mazzei
J A
JA
D002908:Chronic Disease; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D013997:Time Factors