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Hypoxemia in patients with COPD: cause, effects, and disease progression.

Authors
  • Kent, Brian D
  • Mitchell, Patrick D
  • McNicholas, Walter T
Type
Published Article
Journal
International journal of chronic obstructive pulmonary disease
Publication Date
Jan 01, 2011
Volume
6
Pages
199–208
Identifiers
DOI: 10.2147/COPD.S10611
PMID: 21660297
Source
Medline
Keywords
License
Unknown

Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability internationally. Alveolar hypoxia and consequent hypoxemia increase in prevalence as disease severity increases. Ventilation/perfusion mismatch resulting from progressive airflow limitation and emphysema is the key driver of this hypoxia, which may be exacerbated by sleep and exercise. Uncorrected chronic hypoxemia is associated with the development of adverse sequelae of COPD, including pulmonary hypertension, secondary polycythemia, systemic inflammation, and skeletal muscle dysfunction. A combination of these factors leads to diminished quality of life, reduced exercise tolerance, increased risk of cardiovascular morbidity, and greater risk of death. Concomitant sleep-disordered breathing may place a small but significant subset of COPD patients at increased risk of these complications. Long-term oxygen therapy has been shown to improve pulmonary hemodynamics, reduce erythrocytosis, and improve survival in selected patients with severe hypoxemic respiratory failure. However, the optimal treatment for patients with exertional oxyhemoglobin desaturation, isolated nocturnal hypoxemia, or mild-to-moderate resting daytime hypoxemia remains uncertain.

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