Association between oxygen therapy and adverse events in hypercapnic COPD patients

Title: Association between oxygen therapy and adverse events in hypercapnic COPD patients
Author(s): S Joomye, A Betts, J Joomye, D O’Sullivan, S Donnelly,S Lane, E Moloney, C Varghese, M Khooblall, A Subramaniam
Institution: Tallaght University Hospital
Poster: Click to view poster
Category: General Respiratory and Sleep
Abstract: Introduction

Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality worldwide. Oxygen therapy is an essential component in the acute management of COPD exacerbations but there is a risk of triggering hypercapnic respiratory failure. Oxygen should be prescribed to achieve target saturations (Sp02) of 88-92% to prevent adverse outcomes1.


Aim

To investigate in-hospital adverse events related to excess supplemental oxygen in COPD patients with chronic hypercapnia (PaC02 > 6.0kPa).


Methods
A study of 50 hypercapnic COPD patients admitted to hospital between September 2019 and January 2020. Data including demographics, blood gases, Sp02, and in-hospital adverse events were collected retrospectively from medical records. Patients on LTOT were excluded. Adverse outcomes included decompensated type 2 respiratory failure (T2RF) requiring BIPAP and intensive care unit admission.

Results
21(42%) were male and 29(58%) were female. Mean age was 68.7 years. 40(80%) patients had their target Sp02 range charted. Out of these, 23(57%) received over-oxygenation and 7 (30%) required BIPAP and 4(17%) were escalated to ICU. Out of the 10(20%) who did not have parameters charted, 6 (60%) received over-oxygenation without any adverse events.

Conclusion
Adherence to guidelines on Oxygen therapy in COPD patients remain suboptimal. Education programme directed at healthcare staffs is required to meet standardised practice.