COPD-HOME OXYGEN

SUMMARY

1. The focus of O₂ therapy for patients with COPD or in respiratory distress is to give them enough O₂ to achieve 90% O₂ saturation. This prolongs survival.

2. This is a required end-point in initial management! Not treating hypoxia causes further end-organ damage, worsening pulmonary vasoconstriction, and a downward spiral to death.

3. Criteria for starting continuous O₂: (1) resting PaO₂ < 55mmHg or SaO₂ < 88% with evidence of cor pulmonale (2) resting PaO₂ < 59mmHg or SaO₂ < 89%

4. Criteria for evidence of cor pulmonale: (1) clinical evidence of right heart failure (2) P-pulmonale on ECG ( > 2.5 mm P wave height in leads II, III, and AVF) (3) Hct > 55% (Cor-pulmonale causes chronic hypoxia, which causes polycythemia).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].