Neurological Effects of Oxygen

The use of oxygen in acute exacerbations of chronic obstructive pulmonary disease: a prospective audit of pre-hospital and hospital emergency management

“…It was reported over 50 years ago that administration of high-flow oxygen to patients with an exacerbation of COPD could worsen respiratory acidosis 2,3 , which in turn is an adverse prognostic factor 4 . The British Thoracic Society recommend that a fractional inspired oxygen concentration (FiO 2 ) of no more than 0.28 is given to COPD patients until the result of arterial blood gas analysis is available 5 .…”

Hypercapnia and oxygen therapy in older asthmatic patients

“…This may evolve within minutes [13,15]. Our patient's recovery demonstrates the capacity of the older hypercapnic asthmatic patient to recover with simple measures such as reduced oxygen administration [2,16,17], although assisted ventilation will often be required [18] if hypercapnia is acute and reflects fatigue rather than over-oxygenation.…”

“…Westlake et al [2], Aubier et al [13], Donald [16], and Prime and Westlake [17] described respiratory deterioration in chronically hypercapnic patients after unrestricted oxygen therapy, which improved with reducing oxygen administration. A chronic PaCO 2 of more than 50 mmHg increases the risk of progressive hypercapnia in stable COPD [15], and titrated oxygen therapy aiming to maintain the SaO 2 at 90-92% is recommended [3].…”

The Use of Artificial Respiration in Pulmonary Emphysema Accompanied by High Carbon Dioxide Levels 1

“…A syndrome resembling carbon dioxide narcosis, which may be precipitated by the administration of oxygen to patients with advanced emphysema, has attracted increasing attention in recent years, although few reports on this subject have appeared in the literature (1)(2)(3)(4)(5)(6)(7). A similar response to oxygen has been described by Marshall and Rosenfeld (8) in experimental animals anesthetized with barbiturates or morphine.…”