Need to Understand COAD/COPD and the issue with Oxygen

[AussieKylie]

I am having a problem understanding COAD/COPD patients and the issue with oxygen. Can some one assist me to understand this in an understandable way. This diagnosis has always had me stumped????:trout:

[gt4everpn, BSN, RN]

well someone with copd has problems with their alveoli. the alveoli aid in gas exchange. in copd the alveoli do not have surfactant, which keep them open. therefore copd pt's have trouble expiring air and use up much energy trying to take breaths. as far as the o2 thing, copd pt's are used to retaining larger than normal amounts of carbon dioxide, because of their inability to expire air( which contains co2) . since they're used to retaining so much co2 the body ( resp center in brain) normal to large amounts of o2 are toxic to the body, thats why copd pt's can't have o2- hope this is understandable!

[msdobson]

well someone with copd has problems with their alveoli. the alveoli aid in gas exchange. in copd the alveoli do not have surfactant, which keep them open. therefore copd pt's have trouble expiring air and use up much energy trying to take breaths. as far as the o2 thing, copd pt's are used to retaining larger than normal amounts of carbon dioxide, because of their inability to expire air( which contains co2) . since they're used to retaining so much co2 the body ( resp center in brain) normal to large amounts of o2 are toxic to the body, thats why copd pt's can't have o2- hope this is understandable!

excellent response gt! however, i have a request myself. :wink2: i'm an old(er!) guy, and i love reading your posts, but the green font is killing my eyes. any chance you could post in black? :bowingpur

cheers,

mike

[omni123]

Patients with COPD are stimulated to breathe by a lack of oxygen, which is the opposite of other people. Patients (and everyone else) that do not have COPD are stimulated to breathe as a result of an increased CO2 level, not because of a lack of oxygen. Therefore, if you have a COPD patient on a high flow rate of oxygen, he/she will not be stimulated to breathe and that, of course, is not good - which is why COPD patients are usually on only lower flow rates. I believe that's what you are asking...feel free to correct me if I'm wrong...

[Nemhain]

According to Brunner & Suddarth's Textbook of Medical Surgical Nursing (10th ed.), "...because hypoxemia stimulates respiration in the patient with severe COPD, increasing the oxygen flow to a high rate may greatly raise the patient's blood oxygen level. At the same time, this will suppress the respiratory drive, causing increased retention of carbon dioxide and CO2 narcosis..."

[NOLA RN]

It is actually the amount of O2 being delivered to the tissue that stimulates COPD patients to breath, not the FiO2. For this reason, it is imperative to monitor SpO2/SaO2 levels and titrate O2 as levels increase. If sats are less than 88%, give whatever FiO2 necessary to provide adequate oxygenation to the patient.