Journal
CLINICAL MEDICINE
Volume 2, Issue 5, Pages 449-451Publisher
ROY COLL PHYS LONDON EDITORIAL OFFICE
DOI: 10.7861/clinmedicine.2-5-449
Keywords
chronic obstructive pulmonary disease; hypercapnic respiratory failure; respiratory acidosis
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Treatment with high-flow oxygen in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can cause or aggravate acute hypercapnic respiratory failure and adversely affect prognosis. National guidelines for the management of COPD recommend an initial fractional inspired oxygen concentration (FiO(2)) of no more than 0.28. However, a prospective audit of 101 consecutive episodes of AECOPD demonstrated that oxygen therapy with an FiO(2) in excess of 0.28 is common, potentially deleterious and predominantly initiated in the ambulance. Patient awareness, aids to disease identification and ambulance protocols are likely to hold the key to improvement in the acute care of these patients.
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