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Published in: Critical Care 5/2012

01-10-2012 | Viewpoint

Oxygen-induced hypercapnia in COPD: myths and facts

Authors: Wilson F Abdo, Leo MA Heunks

Published in: Critical Care | Issue 5/2012

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Abstract

During our medical training, we learned that oxygen administration in patients with chronic obstructive pulmonary disease (COPD) induces hypercapnia through the 'hypoxic drive' mechanism and can be dangerous. This mindset frequently results in the reluctance of clinicians to administer oxygen to hypoxemic patients with COPD. However, this fear is not based on evidence in the literature. Here, we will review the impact and pathophysiology of oxygen-induced hypercapnia in patients with acute exacerbation of COPD and recommend a titrated oxygen management.
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Literature
1.
go back to reference Davies CE, Mackinnon J: Neurological effects of oxygen in chronic cor pulmonale. Lancet. 1949, 2: 883-885.CrossRefPubMed Davies CE, Mackinnon J: Neurological effects of oxygen in chronic cor pulmonale. Lancet. 1949, 2: 883-885.CrossRefPubMed
2.
3.
go back to reference Milic-Emili J, Aubier M: Some recent advances in the study of the control of breathing in patients with chronic obstructive lung disease. Anesth Analg. 1980, 59: 865-873.CrossRefPubMed Milic-Emili J, Aubier M: Some recent advances in the study of the control of breathing in patients with chronic obstructive lung disease. Anesth Analg. 1980, 59: 865-873.CrossRefPubMed
4.
go back to reference Aubier M, Murciano D, Milic-Emili J, Touaty E, Daghfous J, Pariente R, Derenne JP: Effects of the administration of O2 on ventilation and blood gases in patients with chronic obstructive pulmonary disease during acute respiratory failure. Am Rev Respir Dis. 1980, 122: 747-754.CrossRefPubMed Aubier M, Murciano D, Milic-Emili J, Touaty E, Daghfous J, Pariente R, Derenne JP: Effects of the administration of O2 on ventilation and blood gases in patients with chronic obstructive pulmonary disease during acute respiratory failure. Am Rev Respir Dis. 1980, 122: 747-754.CrossRefPubMed
5.
go back to reference Robinson TD, Freiberg DB, Regnis JA, Young IH: The role of hypoventilation and ventilation-perfusion redistribution in oxygen-induced hypercapnia during acute exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000, 161: 1524-1529.CrossRefPubMed Robinson TD, Freiberg DB, Regnis JA, Young IH: The role of hypoventilation and ventilation-perfusion redistribution in oxygen-induced hypercapnia during acute exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000, 161: 1524-1529.CrossRefPubMed
6.
go back to reference Aubier M, Murciano D, Fournier M, Milic-Emili J, Pariente R, Derenne JP: Central respiratory drive in acute respiratory failure of patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1980, 122: 191-199.CrossRefPubMed Aubier M, Murciano D, Fournier M, Milic-Emili J, Pariente R, Derenne JP: Central respiratory drive in acute respiratory failure of patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1980, 122: 191-199.CrossRefPubMed
7.
go back to reference Hanson CW, Marshall BE, Frasch HF, Marshall C: Causes of hypercarbia with oxygen therapy in patients with chronic obstructive pulmonary disease. Crit Care Med. 1996, 24: 23-28. 10.1097/00003246-199601000-00007.CrossRefPubMed Hanson CW, Marshall BE, Frasch HF, Marshall C: Causes of hypercarbia with oxygen therapy in patients with chronic obstructive pulmonary disease. Crit Care Med. 1996, 24: 23-28. 10.1097/00003246-199601000-00007.CrossRefPubMed
8.
go back to reference Denniston AK, O'Brien C, Stableforth D: The use of oxygen in acute exacerbations of chronic obstructive pulmonary disease: a prospective audit of pre-hospital and hospital emergency management. Clin Med. 2002, 2: 449-451.CrossRef Denniston AK, O'Brien C, Stableforth D: The use of oxygen in acute exacerbations of chronic obstructive pulmonary disease: a prospective audit of pre-hospital and hospital emergency management. Clin Med. 2002, 2: 449-451.CrossRef
9.
go back to reference Durrington HJ, Flubacher M, Ramsay CF, Howard LS, Harrison BD: Initial oxygen management in patients with an exacerbation of chronic obstructive pulmonary disease. QJM. 2005, 98: 499-504. 10.1093/qjmed/hci084.CrossRefPubMed Durrington HJ, Flubacher M, Ramsay CF, Howard LS, Harrison BD: Initial oxygen management in patients with an exacerbation of chronic obstructive pulmonary disease. QJM. 2005, 98: 499-504. 10.1093/qjmed/hci084.CrossRefPubMed
10.
go back to reference Wijesinghe M, Perrin K, Healy B, Hart K, Clay J, Weatherall M, Beasley R: Pre hospital oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. Intern Med J. 2011, 41: 618-622. 10.1111/j.1445-5994.2010.02207.x.CrossRefPubMed Wijesinghe M, Perrin K, Healy B, Hart K, Clay J, Weatherall M, Beasley R: Pre hospital oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. Intern Med J. 2011, 41: 618-622. 10.1111/j.1445-5994.2010.02207.x.CrossRefPubMed
11.
go back to reference Austin MA, Wills KE, Blizzard L, Walters EH, Wood-Baker R: Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. BMJ. 2010, 341: c5462-10.1136/bmj.c5462.PubMedCentralCrossRefPubMed Austin MA, Wills KE, Blizzard L, Walters EH, Wood-Baker R: Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. BMJ. 2010, 341: c5462-10.1136/bmj.c5462.PubMedCentralCrossRefPubMed
12.
go back to reference O'Driscoll BR, Howard LS, Davison AG: BTS guideline for emergency oxygen use in adult patients. Thorax. 2008, 63 (Suppl 6): vi1-68.PubMed O'Driscoll BR, Howard LS, Davison AG: BTS guideline for emergency oxygen use in adult patients. Thorax. 2008, 63 (Suppl 6): vi1-68.PubMed
13.
go back to reference Dhillon R: The management of neonatal pulmonary hypertension. Arch Dis Child Fetal Neonatal Ed. 2012, 97: F223-228. 10.1136/adc.2009.180091.CrossRefPubMed Dhillon R: The management of neonatal pulmonary hypertension. Arch Dis Child Fetal Neonatal Ed. 2012, 97: F223-228. 10.1136/adc.2009.180091.CrossRefPubMed
Metadata
Title
Oxygen-induced hypercapnia in COPD: myths and facts
Authors
Wilson F Abdo
Leo MA Heunks
Publication date
01-10-2012
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2012
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc11475

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