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Oxygen-induced hypercapnia in COPD: myths and facts

Wilson F Abdo* and Leo MA Heunks

Author Affiliations

Department of Intensive Care Medicine, Radboud University Nijmegen Medical Center, Geert Grooteplein 10, PO BOX 9101, 6500 HB Nijmegen, The Netherlands

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Critical Care 2012, 16:323  doi:10.1186/cc11475

Published: 29 October 2012


During our medical training, we learned that oxygen administration in patients with chronic obstructive pulmonary disease (COPD) induces hypercapnia through the 'hypoxic drive' mechanism and can be dangerous. This mindset frequently results in the reluctance of clinicians to administer oxygen to hypoxemic patients with COPD. However, this fear is not based on evidence in the literature. Here, we will review the impact and pathophysiology of oxygen-induced hypercapnia in patients with acute exacerbation of COPD and recommend a titrated oxygen management.