Controlled oxygen therapy and carbon dioxide retention during exacerbations of chronic obstructive pulmonary disease.

HYPERCAPNIA; RESPIRATORY insufficiency; CARBON dioxide in the body; OXYGEN therapy; PREVENTION

Hypoxaemic patients with exacerbations of chronic obstructive pulmonary disease (COPD) are at some risk of carbon dioxide (CO[sub 2]) retention during oxygen therapy. We quantified the risk of CO[sub 2] retention with oxygen therapy in COPD in 24 consecutive patients presenting to the accident and emergency department with acute exacerbations associated with hypercapnic respiratory failure (partial arterial pressure of oxygen [PaO[sub 2]] <8 kPa and partial pressure of CO[sub 2] [PaCO[sub 2]] > 6.5 kPa). Only three patients developed clinically important CO[sub 2] retention (defined as a rise in PaCO[sub 2] >1 kPa) with controlled oxygen therapy (24-40% by Venturi mask to maintain the oxygen saturation at 91-92%). These patients presented with more severe hypercapnia, but all three required only low-flow oxygen (24-28%). These findings suggest only a small risk of aggravating hypercapnia with controlled oxygen supplementation. [ABSTRACT FROM AUTHOR]

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