Respiratory response to carbon dioxide stimulation during low flow supplemental oxygen therapy in chronic obstructive pulmonary disease

Ling Ling Chiang, Tsung Chieh Hung, Shun Chuan Ho, Horn Chyuan Lin, Chih Teng Yu, Chun Hua Wang, Han Pin Kuo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and Purpose: Oxygen supplementation is the treatment most commonly used to relieve dyspnea in chronic obstructive pulmonary disease (COPD). There is a lack of data, however, on the response of the respiratory drive to low flow oxygen in severe stable COPD. The purpose of this investigation was to evaluate the magnitude of chemoresponsiveness to low flow supplemental oxygen in patients with COPD of variable severity in terms of mouth occlusion pressure at 100 msec (P0.1), P0.1 and minute ventilation (MV) response to CO2 stimulation, and blood gas tension. Methods: Twenty-six patients with stable COPD of variable severity were divided into two groups: those with mild airway obstruction and normocapnia (n = 14) and those with hyperinflation and hypercapnia (n = 12). Results: Arterial oxygen tension, oxygen saturation, and arterial CO2 tension were significantly increased after oxygen therapy in COPD patients with or without hypercapnia (all p <0.01). COPD patients with hypercapnia had a significantly higher P0.1 (0.7 ± 0.07 kPa) than those with normocapnia (0.3 ± 0.03 kPa, p <0.01). Oxygen significantly decreased the P0.1 adjusted by end tidal CO2 pressure (ΔP0.1/PETCO2) only in patients with hyperinflation and hypercapnia, from 0.2 ± 0.05 to 0.1 ± 0.03 kPa (p <0.05). There was a weak correlation between P0.1/PETCO2 and forced vital capacity (FVC; r = 0.41, p <0.05) or forced expiratory volume in 1 second (FEV1; r = 0.45, p <0.05). In addition, the arterial CO2 tension (P CO2) was inversely related to P0.1/PETCO2 (r = -0.57, p <0.01). The MV with 6% CO2 (MVCO2) was also significantly decreased in the hypercapnic group from 17.9 ± 3.7 to 14.8 ± 4.9 L after oxygen therapy (p <0.01). The maximum inspiratory pressure did not change after oxygen usage in either group. Conclusion: We conclude that short-term oxygen therapy may blunt respiratory response to CO2 in COPD with chronic hypercapnia. Cautious observation of respiratory response is needed during oxygen therapy in COPD patients with a higher magnitude of air-trapping and hypercapnia.

Original languageEnglish
Pages (from-to)607-615
Number of pages9
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Volume101
Issue number9
Publication statusPublished - Sep 1 2002

Fingerprint

Carbon Dioxide
Chronic Obstructive Pulmonary Disease
Oxygen
Hypercapnia
Therapeutics
Arterial Pressure
Ventilation
Pressure
Vital Capacity
Forced Expiratory Volume
Airway Obstruction
Dyspnea
Mouth
Gases
Air
Observation

Keywords

  • Airway obstruction
  • Chronic hypercapnia
  • COPD
  • Oxygen therapy
  • Respiratory drive

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Respiratory response to carbon dioxide stimulation during low flow supplemental oxygen therapy in chronic obstructive pulmonary disease. / Chiang, Ling Ling; Hung, Tsung Chieh; Ho, Shun Chuan; Lin, Horn Chyuan; Yu, Chih Teng; Wang, Chun Hua; Kuo, Han Pin.

In: Journal of the Formosan Medical Association = Taiwan yi zhi, Vol. 101, No. 9, 01.09.2002, p. 607-615.

Research output: Contribution to journalArticle

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abstract = "Background and Purpose: Oxygen supplementation is the treatment most commonly used to relieve dyspnea in chronic obstructive pulmonary disease (COPD). There is a lack of data, however, on the response of the respiratory drive to low flow oxygen in severe stable COPD. The purpose of this investigation was to evaluate the magnitude of chemoresponsiveness to low flow supplemental oxygen in patients with COPD of variable severity in terms of mouth occlusion pressure at 100 msec (P0.1), P0.1 and minute ventilation (MV) response to CO2 stimulation, and blood gas tension. Methods: Twenty-six patients with stable COPD of variable severity were divided into two groups: those with mild airway obstruction and normocapnia (n = 14) and those with hyperinflation and hypercapnia (n = 12). Results: Arterial oxygen tension, oxygen saturation, and arterial CO2 tension were significantly increased after oxygen therapy in COPD patients with or without hypercapnia (all p <0.01). COPD patients with hypercapnia had a significantly higher P0.1 (0.7 ± 0.07 kPa) than those with normocapnia (0.3 ± 0.03 kPa, p <0.01). Oxygen significantly decreased the P0.1 adjusted by end tidal CO2 pressure (ΔP0.1/PETCO2) only in patients with hyperinflation and hypercapnia, from 0.2 ± 0.05 to 0.1 ± 0.03 kPa (p <0.05). There was a weak correlation between P0.1/PETCO2 and forced vital capacity (FVC; r = 0.41, p <0.05) or forced expiratory volume in 1 second (FEV1; r = 0.45, p <0.05). In addition, the arterial CO2 tension (P CO2) was inversely related to P0.1/PETCO2 (r = -0.57, p <0.01). The MV with 6{\%} CO2 (MVCO2) was also significantly decreased in the hypercapnic group from 17.9 ± 3.7 to 14.8 ± 4.9 L after oxygen therapy (p <0.01). The maximum inspiratory pressure did not change after oxygen usage in either group. Conclusion: We conclude that short-term oxygen therapy may blunt respiratory response to CO2 in COPD with chronic hypercapnia. Cautious observation of respiratory response is needed during oxygen therapy in COPD patients with a higher magnitude of air-trapping and hypercapnia.",
keywords = "Airway obstruction, Chronic hypercapnia, COPD, Oxygen therapy, Respiratory drive",
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T1 - Respiratory response to carbon dioxide stimulation during low flow supplemental oxygen therapy in chronic obstructive pulmonary disease

AU - Chiang, Ling Ling

AU - Hung, Tsung Chieh

AU - Ho, Shun Chuan

AU - Lin, Horn Chyuan

AU - Yu, Chih Teng

AU - Wang, Chun Hua

AU - Kuo, Han Pin

PY - 2002/9/1

Y1 - 2002/9/1

N2 - Background and Purpose: Oxygen supplementation is the treatment most commonly used to relieve dyspnea in chronic obstructive pulmonary disease (COPD). There is a lack of data, however, on the response of the respiratory drive to low flow oxygen in severe stable COPD. The purpose of this investigation was to evaluate the magnitude of chemoresponsiveness to low flow supplemental oxygen in patients with COPD of variable severity in terms of mouth occlusion pressure at 100 msec (P0.1), P0.1 and minute ventilation (MV) response to CO2 stimulation, and blood gas tension. Methods: Twenty-six patients with stable COPD of variable severity were divided into two groups: those with mild airway obstruction and normocapnia (n = 14) and those with hyperinflation and hypercapnia (n = 12). Results: Arterial oxygen tension, oxygen saturation, and arterial CO2 tension were significantly increased after oxygen therapy in COPD patients with or without hypercapnia (all p <0.01). COPD patients with hypercapnia had a significantly higher P0.1 (0.7 ± 0.07 kPa) than those with normocapnia (0.3 ± 0.03 kPa, p <0.01). Oxygen significantly decreased the P0.1 adjusted by end tidal CO2 pressure (ΔP0.1/PETCO2) only in patients with hyperinflation and hypercapnia, from 0.2 ± 0.05 to 0.1 ± 0.03 kPa (p <0.05). There was a weak correlation between P0.1/PETCO2 and forced vital capacity (FVC; r = 0.41, p <0.05) or forced expiratory volume in 1 second (FEV1; r = 0.45, p <0.05). In addition, the arterial CO2 tension (P CO2) was inversely related to P0.1/PETCO2 (r = -0.57, p <0.01). The MV with 6% CO2 (MVCO2) was also significantly decreased in the hypercapnic group from 17.9 ± 3.7 to 14.8 ± 4.9 L after oxygen therapy (p <0.01). The maximum inspiratory pressure did not change after oxygen usage in either group. Conclusion: We conclude that short-term oxygen therapy may blunt respiratory response to CO2 in COPD with chronic hypercapnia. Cautious observation of respiratory response is needed during oxygen therapy in COPD patients with a higher magnitude of air-trapping and hypercapnia.

AB - Background and Purpose: Oxygen supplementation is the treatment most commonly used to relieve dyspnea in chronic obstructive pulmonary disease (COPD). There is a lack of data, however, on the response of the respiratory drive to low flow oxygen in severe stable COPD. The purpose of this investigation was to evaluate the magnitude of chemoresponsiveness to low flow supplemental oxygen in patients with COPD of variable severity in terms of mouth occlusion pressure at 100 msec (P0.1), P0.1 and minute ventilation (MV) response to CO2 stimulation, and blood gas tension. Methods: Twenty-six patients with stable COPD of variable severity were divided into two groups: those with mild airway obstruction and normocapnia (n = 14) and those with hyperinflation and hypercapnia (n = 12). Results: Arterial oxygen tension, oxygen saturation, and arterial CO2 tension were significantly increased after oxygen therapy in COPD patients with or without hypercapnia (all p <0.01). COPD patients with hypercapnia had a significantly higher P0.1 (0.7 ± 0.07 kPa) than those with normocapnia (0.3 ± 0.03 kPa, p <0.01). Oxygen significantly decreased the P0.1 adjusted by end tidal CO2 pressure (ΔP0.1/PETCO2) only in patients with hyperinflation and hypercapnia, from 0.2 ± 0.05 to 0.1 ± 0.03 kPa (p <0.05). There was a weak correlation between P0.1/PETCO2 and forced vital capacity (FVC; r = 0.41, p <0.05) or forced expiratory volume in 1 second (FEV1; r = 0.45, p <0.05). In addition, the arterial CO2 tension (P CO2) was inversely related to P0.1/PETCO2 (r = -0.57, p <0.01). The MV with 6% CO2 (MVCO2) was also significantly decreased in the hypercapnic group from 17.9 ± 3.7 to 14.8 ± 4.9 L after oxygen therapy (p <0.01). The maximum inspiratory pressure did not change after oxygen usage in either group. Conclusion: We conclude that short-term oxygen therapy may blunt respiratory response to CO2 in COPD with chronic hypercapnia. Cautious observation of respiratory response is needed during oxygen therapy in COPD patients with a higher magnitude of air-trapping and hypercapnia.

KW - Airway obstruction

KW - Chronic hypercapnia

KW - COPD

KW - Oxygen therapy

KW - Respiratory drive

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