Patients with COPD (Chronic Obstructive Pulmonary Disease) are not given continuous oxygen therapy because it can lead to a condition called hypercapnia, where there is too much carbon dioxide (CO2) in the blood. This happens because COPD patients often have chronically high levels of CO2, and their bodies adapt to this condition. Their respiratory drive, which is the body's natural response to maintain a balance of oxygen and CO2, becomes more dependent on low oxygen levels than high CO2 levels.
Administering too much oxygen can disrupt this balance, reducing respiratory drive and further CO2 retention, which can be dangerous. This potential danger underscores the need for caution and awareness when managing oxygen therapy for COPD patients, maintaining oxygen saturation levels between 88-92%.
The patients are at risk of hypercapnia
Because patients with long term COPD have "anesthetized" the portion of the brain that uses the CO2 level that triggers respiration. The body the begins to use the blood oxygen sensors in the carotid arteries to trigger respiration. If a patient is given enough O2 to bring the O2 blood levels to a more normal level, these oxygen sensors no longer work and the patient will stop breathing. Many years ago a COPD patient in my hospital turned a COPD patient's O2 from 2 lpm/nc to 7 lpm. The patients slowly went into respiratory arrest and we were unable to resuscitate him. COPD patients on a ventilator can have higher levels of O2 as the ventilator will provide continuous breathing; however weaning long term COPD patients off of the ventilator usually proves problematic and they usually are transferred to an LTAC as it often takes weeks to fully wean the patient off a continuous ventilator. Hope this helps.
John Fields MSN RN/CRRT
The reason why too much oxygen can cause hyperpoxia,which can damage the body cells,tachycardia and can cause issues with other organs.
These pt are incapable of letting off carbon dioxide adequately so continuous oxygen therapy would cause a buildup of carbon dioxide in the blood resulting in hypercapnia
too much oxygen can be dangerous for them. Their body can’t exert oxygen like a non copd patient which means Hypercapnia can occur.
because it could compete with the drive to breath and cause a respiratory arrest
Risk for hypercapnia.
We need to keep pt’s Oxygen level no more than 92%
Continuous high-flow oxygen can increase the risk of oxygen toxicity, can lead to dependency and can lead to further CO2 retention, potentially causing respiratory acidosis.
We nurses typically don't give continuous oxygen to patients with COPD because it would lead to carbon dioxide (CO2 ) retention. Patients with COPD, do rely on low oxygen levels to stimulate breathing, hence administering too much oxygen via continuous flow will work against the goal of oxygenation thereby leading to respiratory failure. The nurses know to provide supplemental oxygen at controlled levels,1-2l/min while monitoring the pulse oxygenation.
Because COPD patients depend on their own carbon dioxide. The arieoli are inflated so there is no room for equal exchange between O2 and CO2.
Too much O2 will lead to hypercapnia and CO2 retention
Because 02 works opposite of those wo copd
High Co2 levels
Patients with COPD and COVID-19 should receive controlled oxygen therapy, but continuous high-flow oxygen is generally not recommended for several reasons:
1. Risk of hypercapnia: COPD patients often have chronic hypercapnia (elevated CO2 levels in the blood). Giving too much oxygen can worsen this condition, potentially leading to respiratory acidosis and respiratory failure.
2. Target oxygen saturation: For COPD patients with COVID-19, the recommended target oxygen saturation (SpO2) is typically lower than for other patients. Guidelines suggest aiming for an SpO2 between 88-92% for COPD patients, rather than the 92-96% target for non-COPD patients.
3. Controlled administration: Oxygen therapy should be carefully titrated and monitored. Starting with lower flow rates and gradually increasing as needed helps avoid complications and ensures the patient receives the appropriate amount of oxygen.
4. Risk of hyperoxia: Excessive oxygen can lead to hyperoxia, which may cause vasoconstriction and potentially worsen ventilation-perfusion mismatch in the lungs.
5. Individualized approach: The oxygen needs of COPD patients with COVID-19 can vary widely. An individualized approach, considering the patient’s baseline condition, severity of COVID-19, and response to treatment, is crucial.
6. Potential for aerosol generation: High-flow oxygen therapies may increase the risk of viral transmission through aerosol generation, which is a concern in the context of COVID-19.
Instead of continuous high-flow oxygen, controlled oxygen therapy should be provided as the first step for hypoxemic COPD patients with COVID-19. If hypoxemia persists, other interventions like high-flow nasal cannula (HFNC) or non-invasive ventilation (NIV) may be considered, but these should be used with caution and close monitoring due to the potential risks of viral transmission and worsening respiratory status
