COPD-MANAGEMENT (OXYGEN & NIV)

SUMMARY

1. Use low inspired concentrations of O₂ to maintain sats 88-92%

2. Monitor using ABG & pulse oximetry.

3. Note risk of worsening hypercapnia. High flow O₂ assoc. with more morbidity.

4. NIV is indicated in hypercapnic respiratory failure (RR > 30 and/or pH < 7.35).

5. Start at low pressures, aim to dec RR & inc pH within an hour (repeat ABG).

6. Indications for invasive ventilation: unable to protect airways, no spontaneous respiration, refractory hypoxia, severe acidosis.

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].