Abstract
Thirty-eight patients with late sequelae of pulmonary tuberculosis (TB seq.) werestudied to clarify whether or not nocturnal oxyhemoglobin desaturation (NOD) could relateto acute exacerbation of chronic respiratory failure (AE). All patients had been untreatedwith home oxygen therapy, because they were not severely hypoxic. We performed sleepstudies, pulmonary function tests and arterial blood gas analysis and investigated pasthistory about AE in each patient.
Twelve patients had experienced AE with right heart failure and they were classified as CHF (congestive heart failure) group. The rest was classified as Non-CHF group. These twogroups were compared as for each variables examined.
There was no difference between the two groups in age, body weight, %VC, FEV1.0%, andawake Pao2. Awake Paco, was significantly higher in CHF group. Although no differencewas observed in baseline Sao2, the degree of NOD was significantly greater in CHF groupwhen evaluated by lowest Sao2 during sleep and 85% desaturation time (total time spentwith Sao2 less than 85%).
Moreover, 21 of Non-CHF and 6 of CHF were studied for cardiac parameters usingright side cardiac catheterization. While the differences of mean pulmonary arterialpressure and cardiac output between the two groups were not significant, pulmonaryarteriolar resistance was higher in CHF group.
We concluded that NOD in TB seq. had a major role in AE with right heart failure. Wespeculated that AE might be caused, at least partly, by pulmonary vasopressor response torecurrent NOD.
