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COPD-HOME OXYGEN

Respiratory

COPD-HOME OXYGEN

1. The focus of 0 2 therapy for patients with COPD or in respiratory distress is to give them enough 0 2 to achieve 90% 0 2 saturation. This prolongs survival.

2. This is a required end-point in initial management! Not treating hypoxia causes further end-organ damage, worsening pulmonary vasoconstriction, and a downward spiral to death.

3. Criteria for starting continuous O 2 : (1) resting PaO 2 < 55mmHg or SaO 2 < 88% with evidence of cor pulmonale (2) resting PaO 2 < 59mmHg or SaO 2 < 89%

4. Criteria for evidence of cor pulmonale: (1) clinical evidence of right heart failure (2) P pulmonale on ECG ( > 2.5 mm P wave height in leads II, III, and AVF) (3) Hct > 55% (Cor pulmonale causes chronic hypoxia, which causes polycythemia.)


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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