FREDERIC ELDRIDGE, M.D., F.A.C.P.; CHARLES GHERMAN, M.D.
The effects of low-flow oxygen administration on arterial blood oxygen tension (PO2) carbon dioxide tension (PCO2), and pH were studied in patients with acute exacerbations of chronic pulmonary disease and who had hypoxemia and hypercapnia while breathing room air. Increases of arterial PO2 in these patients almost always led to rises in arterial PCO2. However, the majority of patients tolerated increases in arterial PO2 to adequate levels without developing large increases in either PCO2 or hydrogen ion concentration. Although there were wide variations in the rise in PCO2 for a given increase in PO2, it was found that patients with low initial PO2 tended to have greater PCO2 rises and that in a given patient the greater the increase in PO2, the greater was the resulting increase in PCO2.
The findings suggest that a majority of patients with respiratory failure consequent to chronic obstructive respiratory disease can be managed with controlled oxygen during an acute exacerbation of their disease, without recourse to tracheostomy and machine-supported respiration. A suggested approach to this method of management is given. The necessity for repeated blood gas analyses for arterial PO2, PCO2, and pH during the care of these patients is stressed.
ELDRIDGE F, GHERMAN C. Studies of Oxygen Administration in Respiratory Failure. Ann Intern Med. ;68:569–578. doi: 10.7326/0003-4819-68-3-569
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Published: Ann Intern Med. 1968;68(3):569-578.
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