[Chronic hypoxia and tissue adaptation (excluding the right heart) in chronic obstructive bronchopathies]

In this report, the authors review the diverse mechanisms of compensation to chronic hypoxaemia, that is principally a displacement to the right of the haemoglobin dissociation curve and polycythaemia which tends to improve the supply of oxygen to the cells. The tissue effects of this chronic hypoxaemia are specified (excluding the right heart). As regards the left ventricle, ventricular function seems to be conserved until late yet there is a risk of arrhythmias which appears to increase proportionately to the degree of desaturation. Chronic respiratory failure produces clear cut neuropsychological deficits which correlate with the degree of hypoxaemia as well as problems with the quality of life and interference with memory. These troubles seem to be limited or even partially reversed by oxygen therapy. These patients also have troubles with urine output of water and sodium and there are also sexual problems as well as peripheral neuropathy.