Hemodynamic effects of supplemental oxygen administration in congestive heart failure

Division of Cardiology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, Pennsylvania, USA.

OBJECTIVES. This study sought to determine the hemodynamic effects of oxygen therapy in heart failure. BACKGROUND. High dose oxygen has detrimental hemodynamic effects in normal subjects, yet oxygen is a common therapy for heart failure. Whether oxygen alters hemodynamic variables in heart failure is unknown. METHODS. We studied 10 patients with New York Heart Association functional class III and IV congestive heart failure who inhaled room air and 100% oxygen for 20 min. Variables measured included cardiac output, stroke volume, pulmonary capillary wedge pressure, systemic and pulmonary vascular resistance, mean arterial pressure and heart rate. Graded oxygen concentrations were also studied (room air, 24%, 40% and 100% oxygen, respectively; n = 7). In five separate patients, muscle sympathetic nerve activity and ventilation were measured during 100% oxygen. RESULTS. The 100% oxygen reduced cardiac output (from 3.7 +/- 0.3 to 3.1 +/- 0.4 liters/min [mean +/- SE], p < 0.01) and stroke volume (from 46 +/- 4 to 38 +/- 5 ml/beat per min, p < 0.01) and increased pulmonary capillary wedge pressure (from 25 +/- 2 to 29 +/- 3 mm Hg, p < 0.05) and systemic vascular resistance (from 1,628 +/- 154 to 2,203 +/- 199 dynes.s/cm5, p < 0.01). Graded oxygen led to a progressive decline in cardiac output (one-way analysis of variance, p < 0.0001) and stroke volume (p < 0.017) and an increase in systemic vascular resistance (p < 0.005). The 100% oxygen did not alter sympathetic activity or ventilation. CONCLUSIONS. In heart failure, oxygen has a detrimental effect on cardiac output, stroke volume, pulmonary capillary wedge pressure and systemic vascular resistance. These changes are independent of sympathetic activity and ventilation.

This article has been cited by other articles:

				M. T. Naughton and S. Andreas Sleep apnoea in chronic heart failure Sleep Apnoea, December 1, 2010; 396 - 420. [Abstract] [Fulltext] [PDF]

				J. H Park, S. Balmain, C. Berry, J. J Morton, and J. J V McMurray Potentially detrimental cardiovascular effects of oxygen in patients with chronic left ventricular systolic dysfunction Heart, April 1, 2010; 96(7): 533 - 538. [Abstract] [Full Text] [PDF]

				M. T. Naughton Filling the Heart Failure Management Void With Positive Airway Pressure Chest, October 1, 2009; 136(4): 953 - 956. [Full Text] [PDF]

				B R O'Driscoll, L S Howard, A G Davison, and on behalf of the British Thoracic Society BTS guideline for emergency oxygen use in adult patients Thorax, October 1, 2008; 63(Suppl_6): vi1 - vi68. [Full Text] [PDF]

				A. Garcia-Touchard, V. K. Somers, L. J. Olson, and S. M. Caples Central Sleep Apnea: Implications for Congestive Heart Failure Chest, June 1, 2008; 133(6): 1495 - 1504. [Abstract] [Full Text] [PDF]

				D. Pevernagie, J. P. Janssens, W. De Backer, M. Elliott, J. Pepperell, and S. Andreas Ventilatory support and pharmacological treatment of patients with central apnoea or hypoventilation during sleep Eur. Respir. Rev., December 1, 2007; 16(106): 115 - 124. [Abstract] [Full Text] [PDF]

				S. Javaheri Treatment of obstructive and central sleep apnoea in heart failure: practical options Eur. Respir. Rev., December 1, 2007; 16(106): 183 - 188. [Abstract] [Full Text] [PDF]

				H. D. Schultz, Y. L. Li, and Y. Ding Arterial Chemoreceptors and Sympathetic Nerve Activity: Implications for Hypertension and Heart Failure Hypertension, July 1, 2007; 50(1): 6 - 13. [Full Text] [PDF]

				R. Beasley, S. Aldington, M. Weatherall, G. Robinson, and D. McHaffie Oxygen therapy in myocardial infarction: an historical perspective J R Soc Med, March 1, 2007; 100(3): 130 - 133. [Full Text] [PDF]

				A. J. Thomson, G. B. Drummond, W. S. Waring, D. J. Webb, and S. R. J. Maxwell Effects of short-term isocapnic hyperoxia and hypoxia on cardiovascular function J Appl Physiol, September 1, 2006; 101(3): 809 - 816. [Abstract] [Full Text] [PDF]

				M. Arzt and T. D. Bradley Treatment of Sleep Apnea in Heart Failure Am. J. Respir. Crit. Care Med., June 15, 2006; 173(12): 1300 - 1308. [Abstract] [Full Text] [PDF]

				S. Iscoe and J. A. Fisher Hyperoxia-Induced Hypocapnia: An Underappreciated Risk Chest, July 1, 2005; 128(1): 430 - 433. [Full Text] [PDF]

				K. S. Bandali, M. P. Belanger, and C. Wittnich Hyperoxia causes oxygen free radical-mediated membrane injury and alters myocardial function and hemodynamics in the newborn Am J Physiol Heart Circ Physiol, August 1, 2004; 287(2): H553 - H559. [Abstract] [Full Text] [PDF]

				S. Andreas, C. Bingeli, P. Mohacsi, T. F. Luscher, and G. Noll Nasal Oxygen and Muscle Sympathetic Nerve Activity in Heart Failure Chest, February 1, 2003; 123(2): 366 - 371. [Abstract] [Full Text] [PDF]

				A. J Thomson, D. J Webb, S. R J Maxwell, and I. S Grant Oxygen therapy in acute medical care BMJ, June 15, 2002; 324(7351): 1406 - 1407. [Full Text] [PDF]

				M. G. Hennersdorf, S. Hillebrand, C. Perings, and B.-E. Strauer Chemoreflexsensitivity in chronic heart failure patients Eur J Heart Fail, December 1, 2001; 3(6): 679 - 684. [Abstract] [Full Text] [PDF]

				L. K. Weaver and S. Churchill Pulmonary Edema Associated With Hyperbaric Oxygen Therapy Chest, October 1, 2001; 120(4): 1407 - 1409. [Abstract] [Full Text] [PDF]

				Task Force for the Diagnosis and Treatment of Chro, W. J. Remme, and K. Swedberg Guidelines for the diagnosis and treatment of chronic heart failure Eur. Heart J., September 1, 2001; 22(17): 1527 - 1560. [PDF]

				S Heindl, C Dodt, M Krahwinkel, G Hasenfuss, and S Andreas Short term effect of continuous positive airway pressure on muscle sympathetic nerve activity in patients with chronic heart failure Heart, February 1, 2001; 85(2): 185 - 190. [Abstract] [Full Text]

				J. K. Shoemaker, H. L. Naylor, C. S. Hogeman, and L. I. Sinoway Blood Flow Dynamics in Heart Failure Circulation, June 15, 1999; 99(23): 3002 - 3008. [Abstract] [Full Text] [PDF]

				S.-Y. Sun, W. Wang, I. H. Zucker, and H. D. Schultz Enhanced peripheral chemoreflex function in conscious rabbits with pacing-induced heart failure J Appl Physiol, April 1, 1999; 86(4): 1264 - 1272. [Abstract] [Full Text] [PDF]

				A. M. Atz, I. Adatia, J. E. Lock, and D. L. Wessel Combined effects of nitric oxide and oxygen during acute pulmonary vasodilator testing J. Am. Coll. Cardiol., March 1, 1999; 33(3): 813 - 819. [Abstract] [Full Text] [PDF]

				J. K. Shoemaker, A. R. Kunselman, D. H. Silber, and L. I. Sinoway Maintained exercise pressor response in heart failure J Appl Physiol, November 1, 1998; 85(5): 1793 - 1799. [Abstract] [Full Text] [PDF]

				P. Ponikowski, T. P. Chua, M. Piepoli, D. Ondusova, K. Webb-Peploe, D. Harrington, S. D. Anker, M. Volterrani, R. Colombo, G. Mazzuero, et al. Augmented Peripheral Chemosensitivity as a Potential Input to Baroreflex Impairment and Autonomic Imbalance in Chronic Heart Failure Circulation, October 21, 1997; 96(8): 2586 - 2594. [Abstract] [Full Text]

				P. Crawford, P. A. Good, E. Gutierrez, J. H. Feinberg, J. P. Boehmer, D. H. Silber, and L. I. Sinoway Effects of supplemental oxygen on forearm vasodilation in humans J Appl Physiol, May 1, 1997; 82(5): 1601 - 1606. [Abstract] [Full Text] [PDF]

				P. van de Borne, R. Oren, E. A. Anderson, A. L. Mark, and V. K. Somers Tonic Chemoreflex Activation Does Not Contribute to Elevated Muscle Sympathetic Nerve Activity in Heart Failure Circulation, September 15, 1996; 94(6): 1325 - 1328. [Abstract] [Full Text]