Adaptation to Anoxia in Chronic Pulmonary Emphysema

Wilson, Russell H.; Borden, Craig W.; Ebert, Richard V.

doi:10.1001/archinte.1951.03810110033003

Cited by 58 publications

(17 citation statements)

References 20 publications

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“…Is it possible to go further than that? An apparent lack of polycythaemic response to hypoxaemia in COPD has been noted in early studies [31,32]. Recently, JOHN et al [12] found that among 101 severe COPD patients (FEV1 37¡2% pred), 13 were anaemic.…”

Section: Copd As a Putative Cause Of Anaemia Of Chronic Diseasementioning

confidence: 94%

The potential impact of anaemia of chronic disease in COPD

Similowski

Agustí²,

MacNee³

et al. 2006

Eur Respir J

153

107

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Anaemia of chronic disease (ACD), with chronically low levels of circulating haemoglobin, is an immune driven abnormality that occurs in many inflammatory diseases, and also in chronic heart failure. Although chronic obstructive pulmonary disease (COPD) is ''traditionally'' associated with polycythaemia, the systemic inflammation that is now recognised as a feature of COPD makes it a possible cause of ACD. If present in COPD, anaemia could worsen dyspnoea and limit exercise tolerance.Preliminary evidence suggests that anaemia in COPD patients may be more prevalent than expected, concerning 10-15% of patients suffering from severe forms of the disease. A database study conducted in 2,524 COPD patients being prescribed long-term oxygen therapy has shown that a low haematocrit is a strong predictor of survival in this population, before body mass index, and is associated with more hospitalisations and a longer cumulative duration of hospitalisation. COPD patients with low haemoglobin levels have a poorer prognosis than COPD patients with normal haemoglobin levels in the event of acute gastrointestinal bleeding or after elective aneurysm repair. Raising haemoglobinaemia through transfusion decreases minute ventilation and work of breathing in COPD patients.These preliminary evidences point to the need to study the prevalence of anaemia, and its physiological and clinical impact in chronic obstructive pulmonary disease. When this body of knowledge is available, the question of the putative benefits of raising haemoglobinaemia in chronic obstructive pulmonary disease will have to be addressed.

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Section: Copd As a Putative Cause Of Anaemia Of Chronic Diseasementioning

confidence: 94%

The potential impact of anaemia of chronic disease in COPD

Similowski

Agustí²,

MacNee³

et al. 2006

Eur Respir J

153

107

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“…It has, for example, been commonly observed that in patients with chronic obstructive airway disease, hypoxemia is often not associated with a significant increase in hemoglobin concentration or hematocrit (1,2). This apparent absence of polycythemic response in these patients has led to some speculation regarding possible mechanisms of bone marrow suppression in chronic pulmonary disease.…”

Section: Introductionmentioning

confidence: 99%

The red cell mass-arterial oxygen relationship in normal man

Weil¹,

Jamieson²,

Brown³

et al. 1968

J. Clin. Invest.

163

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A B S T R A C T The normal relationship between red cell mass measured, with 51chromium-labeled red cells, and arterial oxygen saturation (Sao2) over the range from 97.3 to 83.4% was examined by studying 73 normal men residing at sea level and altitudes of 1600 and 3100 m. A simple, linear relationship between Sao2 and red cell mass was found over the entire range (r =-0.7524, P < 0.001). In contrast, a correlation between red cell mass and arterial 02 tension was found only over the lower half of the range of 02 tensions where Sao2 was also decreased (r = -0.7731, P < 0.005).

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“…Since Wilson et al (1951) reported the apparent lack of polycythaemic response to hypoxia in patients with lung disease, several hypotheses have been put forward in attempts to explain this discrepancy. For example, chronic infection (Wilson et al, 1951), iron deficiency (Fielding and Zorab, 1964), and haemodilution (Shaw and Simpson, 1961) have been suggested as possible causes for the failure of these patients to respond to hypoxia in the normal way.…”

Section: Discussionmentioning

confidence: 99%

“…For example, chronic infection (Wilson et al, 1951), iron deficiency (Fielding and Zorab, 1964), and haemodilution (Shaw and Simpson, 1961) have been suggested as possible causes for the failure of these patients to respond to hypoxia in the normal way. None of these factors, however, seems adequate, when considered singly, to explain the observed discrepancy, though it is possible that they may all play a part.…”

Section: Discussionmentioning

confidence: 99%

“…In human highl-altitude residents (Hurtado et al, 1945) and in patients with congenital cyanotic heart disease (Hallock, 1940) chronic hypoxia leads to polycythaemia in which an increased oxygen-carrying capacity compensates for the reduced arterial oxygen saturation, so that the arterial oxyhaemoglobin concentration often remains normal. However, among patients with chronic lung disease this polycythaemic response to hypoxia has been found to be inconsistent or partially lacking (Wilson et al, 1951). More recently the importance of measuring the red cell mass has been emphasized, as an adequate polycythaemic response may be masked by an increased plasma volume (Shaw and Simpson, 1961).…”

Section: Introductionmentioning

confidence: 99%

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