Document Detail

Oxygen therapy for hypercapnic patients with chronic obstructive pulmonary disease and acute respiratory failure: a randomized, controlled pilot study.
MedLine Citation:
PMID:  11905405     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the effect of oxygen therapy on outcome and on symptomatic hypercapnia. DESIGN: Randomized, controlled, single-blind study. SETTING: Multidisciplinary intensive care unit of a university teaching hospital. PATIENTS: Patients admitted with a clinical diagnosis of an acute exacerbation of chronic obstructive pulmonary disease and a PaO2 <6.6 kPa (50 mm Hg) and PaCO2 >6.6 kPa (50 mm Hg) on air. INTERVENTIONS: Patients received oxygen therapy titrated to increase arterial oxygen tension to >6.6 kPa (50 mm Hg) or >9 kPa (70 mm Hg). Patients in the low-oxygen tension group also received doxapram if they developed an acidosis with pH <7.2, whereas those in the high-oxygen tension group received doxapram if they developed symptomatic acidosis. Bronchodilator, steroid, and antibiotic therapy was standardized. MEASUREMENTS AND MAIN RESULTS: Two patients in the low-oxygen tension group (n = 17) required mechanical ventilation and another one died. No patients in the high-oxygen group (n = 17) had a poor outcome, but this difference was not significant. No patient in either group became comatose or developed an acute cardiac arrhythmia. CONCLUSIONS: Traditional teaching related to oxygen therapy for hypercapnic patients with an acute exacerbation of chronic obstructive pulmonary disease may be incorrect. A large randomized, controlled study is required to confirm this impression.
Charles D Gomersall; Gavin M Joynt; Ross C Freebairn; Christopher K W Lai; Teik E Oh
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  30     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-03-20     Completed Date:  2002-04-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  113-6     Citation Subset:  AIM; IM    
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT.
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MeSH Terms
Oxygen Inhalation Therapy*
Pulmonary Disease, Chronic Obstructive / therapy*
Respiration, Artificial
Respiratory Insufficiency / therapy*
Comment In:
Crit Care Med. 2002 Jan;30(1):258-9   [PMID:  11902279 ]

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