RT Journal Article
SR Electronic
T1 Influence of F<sub>IO<sub>2</sub></sub> on P<sub>aCO<sub>2</sub></sub> During Noninvasive Ventilation in Patients With COPD
JF Respiratory Care
FD American Association for Respiratory Care
SP 383
OP 387
DO 10.4187/respcare.02816
VO 59
IS 3
A1 Augusto Savi
A1 Juçara Gasparetto Maccari
A1 Túlio Frederico Tonietto
A1 Ana Carolina Peçanha Antonio
A1 Roselaine Pinheiro de Oliveira
A1 Marcelo de Mello Rieder
A1 Evelyn Cristina Zignani
A1 Émerson Boschi da Silva
A1 Cassiano Teixeira
YR 2014
UL http://rc.rcjournal.com/content/59/3/383.abstract
AB BACKGROUND: The administration of a high FIO2 to COPD patients breathing spontaneously may result in hypercapnia, due to reversal of preexisting regional hypoxic pulmonary vasoconstriction, resulting in a greater dead space. Arterial blood gas trends have not been reported in these patients. In a 31-bed medical ICU in a teaching hospital we prospectively investigated the response of 17 CO2-retaining COPD patients, after acute respiratory crisis stabilization with noninvasive ventilation, to an FIO2 of 1.0 for 40 min, after having been noninvasively ventilated with an FIO2 of ≤ 0.50 for 40 min. RESULTS: The mean ± SD baseline findings were: PaO2 101.4 ± 21.7 mm Hg, PaCO2 52.6 ± 10.4 mm Hg, breathing frequency 17.8 ± 3.7 breaths/min, tidal volume 601 ± 8 mL, and Glasgow coma score of 14.8 ± 0.3. PaO2 significantly increased (P &lt; .001) when FIO2 was increased to 1.0, but there was no significant change in PaCO2, breathing frequency, tidal volume, or Glasgow coma score. CONCLUSIONS: During noninvasive ventilation with an FIO2 sufficient to maintain a normal PaO2, a further increase in FIO2 did not increase PaCO2 in our CO2-retaining COPD patients.