Abstract
The original reports of Neff and Petty 1 Neff TA Petty TL Long-term continuous oxygen therapy in chronic airway obstruction. Ann Intern Med. 1970; 72: 621-626 Crossref PubMed Scopus (106) Google Scholar that long-term domiciliary oxygen therapy could extend the life of patients with chronic bronchitis and emphysema were made in patients living at altitude in Denver. Although later studies have suggested that similar benefits can be obtained from patients living at sea level, 2 Abraham AS Cole RB Bishop JM Reversal of pulmonary hypertension by prolonged oxygen administration to patients with chronic bronchitis. Circulation Res. 1968; 23: 147-157 Crossref PubMed Scopus (107) Google Scholar , 3 Block AJ Castle JR Keith AS Chronic oxygen therapy treatment of chronic obstructive pulmonary disease at sea level. Chest. 1974; 65: 279-288 Crossref PubMed Scopus (40) Google Scholar , 4 Leggett RJE Kirby BJ Cooke NJ et al. Long-term domiciliary oxygen therapy in chronic cor pulmonale. Thorax. 1976; 31: 414-418 Crossref PubMed Scopus (33) Google Scholar , 5 Stark RD Finnegan P Bishop JM Long-term domiciliary oxygen therapy in chronic bronchitis with pulmonary hypertension. Br Med J. 1973; 3: 467-470 Crossref PubMed Scopus (43) Google Scholar this is yet to be confirmed by a formal controlled trial. The economic importance of chronic bronchitis and emphysema in Britain has led the Medical Research Council to establish a multicenter controlled trial of this treatment, in Birmingham, Sheffield and Edinburgh. The trial started in 1974, and has recruited 87 patients, suffering from cor pulmonale due to chronic bronchitis and emphysema, with pulmonary hypertension, secondary polycythemia and persistent hypoxemia (Po2 below 60 mm Hg when breathing air). These patients, who thus conformed to the “blue and bloated“ pattern 6 Dornhorst AC Respiratory insufficiency. Lancet. 1955; : 1185-1187 PubMed Google Scholar and are non-fighters, (type β) 7 Burrows B Niden AH Fletcher CM Clinical types of chronic obstructive lung disease in London and in Chicago. Am Rev Respir Dis. 1964; 90: 14-27 PubMed Google Scholar , 8 Robin ED O'Neill RP The fighter versus the nonfighter. Control of ventilation in chronic obstructive pulmonary disease. Arch Environ Health. 1963; 7: 125-129 Crossref PubMed Scopus (29) Google Scholar were allocated randomly after initial assessment to either the treatment or control groups. The trial is now entering its final stages and will be reported in 1980. In Edinburgh, 28 patients have entered the trial. Although those patients treated with domiciliary oxygen have shown an improved survival as compared to the randomly allocated matched control patients, the numbers from this one center are too few for the difference yet to be statistically significant.
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