Mixed venous blood oxygen tension is not a good predictor of survival in patients with chronic obstructive lung disease
Chodosowska, E.; Skwarski, K.; Zieliński, J.
European Journal of Respiratory Diseases 71(4): 233-238
1987
ISSN/ISBN: 0106-4339 PMID: 3691680 Document Number: 289139
In a recent study, Kawakami et al. suggested that mixed venous blood oxygenation (P.hivin.VO2) is one of the most important prognostic factors in patients with chronic obstructive lung disease (COLD). The aim of the present study was to evaluate the predictive power of P.hivin.VO2 in 99 of our own patients with COLD. Lung function and pulmonary hemodynamics were investigated in a stable period of the disease. Follow-up studies were done at least 3 years after initial work-up. Observation time was 5.4 .+-. 1.6 years in patients who survived (S) and 2.8 .+-. 2.3 years in patients who died (N-S). The two groups differed significantly in the following variables (mean .+-. SD for survivors and non-survivors): VC 3.0 .+-. 1.0 1 and 2.3 .+-. 8.1 1, FEV1 1.6 .+-. 0.9 1 and 0.9 .+-. 0.4 1, PaO2 9.6 .+-. 1.4 and 8.3 .+-. 1.7 kPa, SaO2 94 .+-. 3% and 90 .+-. 6%, PaCO2 5.0 .+-. 0.9 kPa and 5.9 .+-. 1.1 kPa, mean pulmonary arterial pressure (PAP) 2.6 .+-. 0.7 kPa = 19.5 .+-. 5.6 mmHg and 3.9 .+-. 1.7 kPa = 29.4 .+-. 12.9 mmHg, and hematocrit (Ht) 47 .+-. 5% and 51 .+-. 7%. The following three variables did not differ significantly: cardiac index 3.8 .+-. 1.8 1 and 3.3 .+-. 1.6, P.hivin.VO2 5.6 .+-. 0.9 kPa and 5.3 .+-. 0.9 kPa, and coefficient of oxygen delivery (COD) 5.69 .+-. 2.28 and 5.29 .+-. 2.35. The number of patients with signs of tissue hypoxia (P.hivin.VO2 < 4.66 kPa) was similar in both groups, 7 (S) and 9 (N-S). Lowered COD occurred mainly in patients with lowered P.hivin.VO2. Among all the physiological variables studied, only PAP correlated with survival (p < 0.01). The present data do not confirm that mixed venous blood oxygen tension predicts survival in patients with COLD.