Acute oxygen therapy in COPD

In the acute situation, the aim of oxygen prescription is to correct severe or life-threatening hypoxaemia, without causing unacceptable hypercapnia. The use of controlled oxygen therapy in acute severe exacerbations of COPD, or pneumonia in COPD, is well established. For patients with hypercapnoeic respiratory failure, it may be used with non-invasive ventilation and/or respiratory stimulants to prevent dangerous hypercapnoea when the respiratory drive is lost as hypoxaemia is corrected. As the focus of this chapter is on oxygen therapy in the community, either as long-term regular treatment or as intermittent therapy, acute oxygen therapy in hospital will not be considered further. However, patients' and, sometimes, health-care professionals' experiences of acute oxygen therapy in hospital often determine expectations for oxygen therapy in chronic stable situations where the objectives of treatment are different and do not involve the correction of severe, life-threatening hypoxaemia.

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