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February 16, 1990

Severe Alkalosis During Assisted Ventilation in Chronic Obstructive Pulmonary Disease

Author Affiliations

University of Colorado School of Medicine Denver

University of Colorado School of Medicine Denver

JAMA. 1990;263(7):950. doi:10.1001/jama.1990.03440070036026

To the Editor.—  The otherwise excellent review by Drs Schmidt and Hall1 includes an important misleading statement. Quoting Martin et al,2 the authors indicate a 2-year survival after hospital discharge in acute on chronic respiratory failure of 72%. This statement is in the section on indications for mechanical ventilation. However, only 1 of the 36 patients in the study by Martin et al required intubation and mechanical ventilation. The others were managed without a mechanical ventilator. Thus, it is misleading to include this statement in the section on mechanical ventilation.A number of years ago, we found that 48 consecutive patients with acute on chronic respiratory failure due to chronic obstructive pulmonary disease had a 38% survival at 2 years following the first episode of mechanical ventilation.3