Respiratory failure revisited: acute exacerbations of chronic bronchitis between 1961-68 and 1970-76

Factors determining survival have been analysed retrospectively in 157 admissions of 135 patients with an acute exacerbation of chronic bronchitis and emphysema causing hypoxaemia and carbon dioxide retention. All were treated with controlled oxygen therapy. The death-rate increased with the age of the patient, but was not correlated with the age of the patient, but was not correlated with the severity of hypoxaemia on admission, when the patient was breathing air. The death-rate was significantly higher in those patients in whom arterial [H+] rose above 55 nmol/1 (pH = 7.26) during controlled oxygen therapy. The absence of a rise in the arterial PCO2 during controlled oxygen therapy was not necessarily indicative of a good prognosis, since 5 out of 18 patients showing this response subsequently died in that admission. Only 28% of the 111 patients who left hospital alive survived for five years.