[Should arterial gas values be improved in patients with chronic bronchitic respiratory insufficiency? Value of almitrine dimesylate].

In view of their own effects and haemodynamic repercussions, abnormalities in blood gas values are increasingly recognized as being of major significance for the prognosis of chronic obstructive respiratory diseases. Controlled trials of low flow rate oxygen therapy have demonstrated that correcting hypoxaemia in such cases significantly improved the vital prognosis. Almitrine bismesylate administered in single or multiple daily doses in short-medium-or long term treatment to patients with chronic bronchitis and hypoxaemia has proved capable of increasing PaO2 and, when hypercapnia is present, decreasing PaCO2. In responsive patients, a 1.5 mg/kg dose brings about a 5 mmHg change in PaO2 values and, when applicable, PaCO2 values. Several studies with a 1 year follow-up have shown that almitrine bismesylate represents a breakthrough in the management of respiratory failure consecutive to chronic obstructive respiratory disease. Only long-term controlled trials will demonstrate whether this drug can really improve the vital prognosis and even alter the natural course of the disease.