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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chronic Obstructive Pulmonary Disease. Was On Oxygen Mask. Suddenly No Respiration, Pulse. Began Cardiopulmonary Resuscitation. Reason?

A patient was admitted to the hospital with chronic obstructive pulmonary disease . His PO2 was 55 and PCO2 was 65. A new resident orders 54% oxygen via the venturi mask . One hour later, after the oxygen was placed, the nurse finds the patient with no respiration or pulse. She calls for a Code Blue and begins cardiopulmonary resuscitation ( CPR ). Explain why the patient stopped breathing.
Mon, 18 Mar 2013
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Pulmonologist 's  Response
This sounds like an examination question.

It could be due to many reasons why the patient was found unconscious but based on your report, it could be due to excess amount of oxygen given to a COPD patient with exacerbation who is already on type 2 respiratory failure causing Co2 narcosis. You didn't mention the pH of the blood gas report.

COPD patient have low oxygen in their system. Their brain is set to accept low level of oxygen and when high flow oxygen is given the brain loses it's ability to drive the respiration and patient becomes less responsive. Usually with a machine called BiPAP they respond quite well in such situation.
Patient could also have other events like stroke or a heart attack (MI) leading to loss of consciousness. I hope the patient responded to CPR and mechanical intubation.
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Chronic Obstructive Pulmonary Disease. Was On Oxygen Mask. Suddenly No Respiration, Pulse. Began Cardiopulmonary Resuscitation. Reason?

This sounds like an examination question. It could be due to many reasons why the patient was found unconscious but based on your report, it could be due to excess amount of oxygen given to a COPD patient with exacerbation who is already on type 2 respiratory failure causing Co2 narcosis. You didn t mention the pH of the blood gas report. COPD patient have low oxygen in their system. Their brain is set to accept low level of oxygen and when high flow oxygen is given the brain loses it s ability to drive the respiration and patient becomes less responsive. Usually with a machine called BiPAP they respond quite well in such situation. Patient could also have other events like stroke or a heart attack (MI) leading to loss of consciousness. I hope the patient responded to CPR and mechanical intubation.