Oxygen in COPD- followup

The last podcast on COPD led to some great discussion online about the use of oxygen in patients with COPD.  To address this, Drs. Tim Peck and Colby Redfield are back with a quick summary to clarify how to best use oxygen in patients with COPD.  There’s also another cameo by the one and only Dr. Peter Rosen on how to succeed in emergency medicine.

Here’s the big points:

-Don’t hesitate to give high flow oxygen to hypoxic patients with shortness of breath- especially in the first 30-60 minutes of the resuscitation.

-After the patient has stabilized- give enough oxygen via nasal cannula (or lower flow face mask) to titrate their pulse ox between 88 and 92%.  DO NOT leave patients with COPD on high flow oxygen for long periods of time.

Oxygen in COPD- followup

Here are some relevant references for further reading.

1. New, A.  Oxygen: kill or cure? Prehospital hyperoxia in the COPD patient.  Emerg Med J. 2006 February; 23(2): 144–146.

2. Austin MA et al. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: Randomised controlled trial. BMJ 2010 Oct 18; 341:c5462. 

3. Kilgannon JH, et al. Association Between Arterial Hyperoxia Following Resuscitation From Cardiac Arrest and In-Hospital Mortality. JAMA Vol 303, No 21, June 2, 2010;2165-2171. 

4. Cornet AD, Kooter AJ, Peters MJ, Smulders YM. The potential harm of oxygen therapy in medical emergencies. Crit Care. 2013;17(2):313.