Evidence-based On-call

Exacerbation of Chronic Obstructive Pulmonary Disease

Therapy

Give oxygen if hypoxic (paO₂<8.0 kPa) ^a

via mask or nasal cannula. ^d
Use low concentrations to prevent CO₂ narcosis and monitor pCO₂ levels ^d

Why?

It improves oxygen saturation (on average by 8%), and relieves symptomatic dyspnoea ^a

Oxygen helps relieve symptomatic dyspnoea

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
severe COPD or interstitial lung disease and hypoxia ^a	28% oxygen by face mask	air by face mask	improvement in breathing at minutes	48%	67% (18% to 140%)	3 (2 to 8)