Why do you not give oxygen to COPD patients?

An estimated 16 million adults in the US are diagnosed with COPD, acronym for Chronic Obstructive Pulmonary Disease. Patients with the progressive lung disease experience difficulty in breathing as a result of the obstructed airflow in the lungs. While treatment protocols are in place to deal with the condition, there are certain options that need to be explicitly followed to avoid possible aggravation of the condition. Following subsections offer a detailed look at the diseases, symptoms and treatment, also answering the question – Why do you not give oxygen to COPD patients? This will help individuals handle the condition more effectively and seek the right treatment.

Overview of COPD

Attributed to long-term exposure to irritants such as cigarette smoke, air pollution, and harmful particles that damage the lungs over time, COPD is broadly classified into two types – chronic bronchitis and emphysema. Chronic bronchitis involves inflammation and narrowing of the airways, resulting in increased production of mucus and persistent coughing. Emphysema, causes damage to the air sacs in the lungs, reducing elasticity and making it harder for normal expansion and contraction during breathing. Individuals may sometimes be afflicted with both conditions, and COPD is generally progressive in nature.

Common symptoms of COPD

Symptoms that commonly indicate COPD may vary, and depend on the stage and severity of the disease, though certain symptoms are common as listed below:

• Shortness of breath – Usually starts gradually and worsens over time. Initially, experienced during physical activity, and as the disease progresses, is experienced even when resting.
• Chronic cough: Persistent cough that produces mucus – typically worse in the morning with yellow, green, or clear sputum.
• Wheezing: Common symptom with a whistling or squeaking sound during breathing as a result of the narrowed airways.
• Chest tightness: Heaviness or tightness in the chest, aggravating breathing difficulty.
• Reduced exercise tolerance: Breathlessness results in decreased exercise tolerance and decreased quality of life.
• Fatigue: Constant feeling of tiredness and lack of energy due to the increased effort required to breathe.
• Respiratory infections: Prone to frequent respiratory infections – cold, bronchitis, or pneumonia.
• Bluish lips or fingertips: Discoloration of the lips or fingertips, (medically labelled as cyanosis) due to low oxygen levels in the blood.

Treatment of COPD

Treatment typically relies on a combination of lifestyle changes, medications, pulmonary rehabilitation, and, in certain instances, surgical intervention. Supplemental oxygen is also a part of protocol but only in a controlled manner. The purpose is to relieve symptoms, slow the progression of the disease, and improve overall lung function and quality of life. Common protocols include the following:

• Quitting smoking is the first and most important requirement to slow down the progression of the disease and improve symptoms.
• Various medications used as treatment include bronchodilators, corticosteroids, and combination inhalers.
• Pulmonary rehabilitation, a structured program that combines exercise training and breathing exercises, to improve exercise capacity, reduce symptoms, and enhance quality of life.
• Supplemental oxygen in a controlled manner may sometimes be prescribed when blood oxygen levels are low.
• Surgical interventions such as lung volume reduction surgery or lung transplantation may also be considered when other treatments are ineffective.
• COPD exacerbations, may require additional treatment, including short-term use of oral corticosteroids or antibiotics, to manage acute flare-ups.
• Lifestyle changes, include avoiding exposure to irritants, good respiratory hygiene, moderate physical activity and a healthy diet.

Why do you not give oxygen to COPD patients?

Oxygen therapy, as mentioned above is part of treatment for COPD, for patients with low blood oxygen levels. However, oxygen therapy for COPD should be prescribed and monitored by a qualified healthcare professional based on individual patient assessment and specific oxygenation needs. All COPD patients will not require oxygen therapy, and in some cases, may not be appropriate. This is because excessive oxygen supplementation can potentially lead to complications – oxygen toxicity or respiratory depression.

What is the target oxygen saturation levels for patients with COPD?

The target oxygen saturation levels for patients with COPD could be between 88% and 92%. Various methods may be used to assess oxygen saturation levels, such as pulse oximetry (a non-invasive test that measures oxygen saturation in the blood) or arterial blood gas (ABG) analysis (invasive test that provides more accurate information about blood oxygen levels).

Methods for oxygen delivery to patients with COPD?

Common methods of oxygen delivery for COPD patients include the following:

• Nasal cannula: The most common and non-invasive method of oxygen delivery, this involves a small plastic tube with prongs that are inserted into the nostrils. The oxygen is then delivered in a continuous flow through the prongs. The flow rate is typically prescribed by the healthcare professional and can be adjusted to achieve the desired oxygen saturation levels.
• Oxygen mask: This method involves the use of an oxygen mask that covers the nose and mouth, and delivers oxygen in a continuous flow. Masks can be helpful for COPD patients who require higher oxygen flow rates or who have difficulty using a nasal cannula due to nasal congestion or other reasons.
• Venturi mask: A specialized oxygen mask that delivers a precise amount of oxygen at a specific flow rate. It is designed to deliver a more precise oxygen concentration, which can be helpful for COPD patients who require precise oxygen titration.
• Oxygen concentrator: A device that extracts oxygen from room air and delivers it through a nasal cannula or a mask. It is a portable and convenient option for providing oxygen to COPD patients at home or in other settings, and it does not require the use of oxygen cylinders.

What are the common risks of uncontrolled oxygen delivery?

One of the reasons for hospital admissions is acute exacerbation of COPD. While healthcare professionals consider putting patients on high concentrations of inspired oxygen, studies have indicated that this could be dangerous for patients with COPD. While there are guidelines against this practice, this practice continues, and the same has been documented over the years. For patients with COPD, uncontrolled oxygen delivery can result in dangerous levels of oxygen as well as carbon dioxide.

Amanda Collins

Education: Master’s in Clinical Nutrition from Tufts University. Experience: 6 years of experience as a registered dietitian and freelance writer, creating content on nutritional science and weight management for various health websites.