Copd Exacerbation and Pulmonary Hypertension Trial

During admittance due to acute exacerbation of chronic obstructive lung disease will patience have an echocardiography to examine their pulmonary pressure. If patient have a tricuspidal return gradient above 40 mmHg, they will receive treatment with a phosphordiesterase-5-inhibitor, Sildenafil.

• Sildenafil (Drug), also known as Vizarsin: Sildenafil in standard dosage

Primary outcomes

• Time alive and out of hospital [365 days]

Secondary outcomes

• Time to "prednisolon and/or antibiotica"-needing exacerbation of COPD or death [365 days]
• Death within 90 days [90 days]
• Death within 1 year [365 days]
• Alive and without exacerbation of COPD on day 365 [365 days]
• Clinical cure [14 days]
• Number of readmissions due to exacerbations of COPD [365 days]
• Number of days with non-invasive ventilation (NIV) or respirator during admittance [14 days]
• Delta Pa(O2) [4 days]
• Delta Pa(CO2) [4 days]
• Delta(pH) [4 days]
• Change in FEV1 [90 days]
• Change in COPD Assesment Test (CAT) [29 days]
• Change in Body Mass Index (BMI) [90 days]
• Delta(TR-gradient) [4 days]

Sex: All, ages: 40 Years to any

Inclusion Criteria:

* COPD verified by specialist and spirometry
* Admitted with the diagnosis "acute exacerbation of COPD"
* TR-gradient ≥40 mmHg verified by specialist and echocardiography
* Informed consent

Exclusion Criteria:

* Known pulmonal hypertension
* Known heart disease which affects the pump function of the heart
* Men <40 years
* Women <55 years
* Not-menopauseal women <55 years (Menopause is defined as no menstruation within 12 months.)
* Severe mental illness which significantly complicates cooperation
* Severe language difficulties which significantly complicates cooperation
* known allergy to Sildenafil
* Sildenafil consumption ≥50 mg / week due to other indications