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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chronic Obstructive Pulmonary Disease. Oxygen Via Venturi Mask. Tried CPR. Stopped Breathing. Why?

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.
Fri, 8 Mar 2013
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Critical Care Specialist 's  Response
Hello
Well come to health care magic
Dear , actually in normal healthy individuals respiratory drive is mantained by the stimulation of the respiratory center of the brain by increase in the PCO2, but in COPD patients due to persistantly high levels of PCO2 like PCO2 OF 65 in your patient their chemoreceptors in the respiratory center of the brain become adopted to CO2 and will not respond to the increase in PCO2 level, so in COPD patients the respiratory drive is not mantained by increase in PCO2 Level, however the respiratory centers of their brain get stimulated by the fall in the PO2 i.e the respiratory drive of COPD patients is maintained by hypoxia i.e low levels of PO2 like PO2 of 55 in your patient. So if you give high concentration of O2 to COPD patients , their PO2 level will rise and the hypoxic drive for breathing is lost and patient lands in to respiratory arrest .There fore in COPD patients only that much amount of O2 is given which will keep their SPO2( saturation of Hb with O2) between 88 to 92%
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Chronic Obstructive Pulmonary Disease. Oxygen Via Venturi Mask. Tried CPR. Stopped Breathing. Why?

Hello Well come to health care magic Dear , actually in normal healthy individuals respiratory drive is mantained by the stimulation of the respiratory center of the brain by increase in the PCO2, but in COPD patients due to persistantly high levels of PCO2 like PCO2 OF 65 in your patient their chemoreceptors in the respiratory center of the brain become adopted to CO2 and will not respond to the increase in PCO2 level, so in COPD patients the respiratory drive is not mantained by increase in PCO2 Level, however the respiratory centers of their brain get stimulated by the fall in the PO2 i.e the respiratory drive of COPD patients is maintained by hypoxia i.e low levels of PO2 like PO2 of 55 in your patient. So if you give high concentration of O2 to COPD patients , their PO2 level will rise and the hypoxic drive for breathing is lost and patient lands in to respiratory arrest .There fore in COPD patients only that much amount of O2 is given which will keep their SPO2( saturation of Hb with O2) between 88 to 92%