The hypoxaemia in chronic obstructive pulmonary disease (COPD) and its management

Chronic hypoxaemia < or = 55 mmHg, induces various clinical and physiological consequences in patients with stable COPD: dyspnoea, decrease in exercise performances, erythrocytosis impairment of neuropsychological functions, pulmonary hypertension, right ventricular heart failure, all of these troubles impairing quality of life and vital prognosis. To restore a PaO2 > 60 mmHg (or SaO2 > 90%), long term oxygen therapy (LTOT) is the best method in the management of COPD with severe chronic respiratory failure. For patients with PaO2 55-70 mmHg. Almitrine bismesylate a piperazine derivative improving the ventilation/perfusion matching, used in low dosage and in sequential administration, is a useful drug to increase the PaO2 and so, to delay but not to avoid LTOT in responder patients when PaO2 remains < or = 55 mmHg.