Avoidance of high concentration oxygen in chronic obstructive pulmonary disease

Abstract

Routine use may also be harmful in several other medical emergencies

An audit of hypoxaemia, hyperoxaemia, hypercapnia and acidosis in blood gas specimens: Table 1–

“…Although it can be assumed that blood gas samples are usually taken from hospital patients at the highest risk of hypoxaemia, these results demonstrate that severe uncorrected hypoxaemia was relatively uncommon in this large database compared with the high prevalence of iatrogenic hyperoxaemia and hypercapnia, both of which may be associated with increased mortality [1][2][3][4][5][6][7][8]. Because the data were anonymised, the inspired oxygen concentration could not be validated and it was not possible to review the results by disease group or by outcome.…”

“…In the past, many clinicians acted cautiously by giving high concentrations of oxygen to all potentially hypoxaemic patients and a culture evolved that ''more is better''. However, since the 1960s, it has been known that some patient groups, particularly those with chronic obstructive pulmonary disease (COPD), are especially vulnerable to uncontrolled oxygen therapy and a recent randomised study showed that mortality in this patient group was doubled when high-concentration oxygen was used compared with controlled oxygen therapy [1][2][3][4]. It has also been demonstrated that hyperoxaemia is associated with increased mortality in patients with stroke, and in survivors of cardiac resuscitation and critically ill patients in the intensive care unit (ICU) [5][6][7].…”

“…Many causative agents are considered to be involved in the pathogenesis [1][2][3][4][5]. Geneenvironment interactions offer the potential for strengthening the evidence of causation between exposures and sarcoidosis.…”

“…Sarcoidosis susceptibility depends on both environmental and genetic modifiers [1,4,5]. Inflammation in sarcoidosis is characterised by ongoing T-cell and macrophage activity and granuloma formation reflected by an increase of serological markers of inflammation or abnormality in glucose metabolism demonstrated as high uptake on 18 F-FDG PET/CT [4,9].…”

“…Inflammation in sarcoidosis is characterised by ongoing T-cell and macrophage activity and granuloma formation reflected by an increase of serological markers of inflammation or abnormality in glucose metabolism demonstrated as high uptake on 18 F-FDG PET/CT [4,9]. Moreover, the endogenous antioxidant defence was found to be significantly reduced in sarcoidosis, indicating that oxidative c…”