Akut Solunum Yetmezliği Olan KOAH Hastalarında İlave Oksijen Tedavisinin Hipoksi Ve Hiperkapniye Etkisi

Background: Hypoxemia and hypercapnia are frequently encountered in chronic obstructive pulmonary disease (COPD) patients with acute attack. Objectives: To investigate the effect of 2 L/min oxygen given with nasal cannula on hypoxemia and hypercapnia in COPD patients with respiratory failure. Methods: Twenty-six type I (Group I) and 36 type II (Group II) respiratory failure patients were included in the study. The patients' initial clinical and laboratory findings were obtained. Spirometric examination and arterial blood gas (ABG) analysis were repeated after the administration of optimal medical therapy including 2 L/min oxygen given with nasal cannula. The patients whose PaCO2 values increased more than 10 mmHg with the treatment were also grouped as Group III, and their comparison was made with the rest of the patients (Group IV). Results: Among the initial laboratory parameters; PaO2 was lower in Group II (pl0.001). Increases in PaO2 values with the treatment in both groups were statistically significant (pl0.001). With the treatment PaO2 value stayed under 60 mmHg in 23 patients (88.5%) and 26 patients (77.2%) in Group I and II, respectively (pl0.05). Final PaCO2 values were found higher in 21 patients (28.8%), and this was more than 10 mmHg in 7 (11.3%) patients (Group III). All but one of these patients belonged to Group II (pg0.05). In Group III, longer disease duration and higher rate of cor pulmonale were found to be statistically significant when compared with Group IV (pl0.05). Conclusion: Two L/min oxygen given with nasal cannula is usually not sufficient to improve hypoxemia in COPD patients with acute attack, and oxygen therapy mentioned increases PaCO2 further in 15-20% of hypercapneic patients. Key words: COPD, Supplemental oxygen therapy, Hypoxemia, Hypercapnia.