Errors in Management of Patients Dying of Chronic Obstructive Lung Disease

Recent advances in the understanding of chronic obstructive lung disease have led to the general acceptance of several principles of therapy. The primary aim of management is the maintenance of adequate alveolar ventilation. To this end, satisfactory therapy requires the prompt treatment of pulmonary infection and the avoidance of respiratory-depressant drugs. Severe hypoxemia must be alleviated by oxygen, and life threatening hypoventilation corrected by mechanical ventilation. The measures alone often are effective in relieving heart failure secondary to the primary lung disease. The extent to which adherence to the above therapeutic principles contributes to patient survival has not been objectively evaluated. This report analyzes the medical management of a group of patients dying of chronic obstructive disease in the medical wards of two teaching hospitals. The findings provide the basis for revising management of these patients. Materials and Methods Selection of Patients.— The records of all patients dying with diagnosed