Randomised controlled trial: effect of high flow oxygen in COPD
Is high flow or titrated oxygen better for patients in a pre-hospital setting?
Chronic obstructive pulmonary disease (COPD), a slowly progressive lung disease that includes chronic bronchitis and emphysema, is characterised by episodes with worsening of the symptoms such as cough, sputum production, and breathlessness. These episodes are called acute exacerbations. Airways are narrowed in COPD and the flow of air in and out of lungs is limited so it would seem intuitive that, when exacerbations occur, “the more the better” should be the ruling principle for giving oxygen to these patients. Still, it has been suggested for decades that, paradoxically, oxygen may be harmful for people with acute exacerbations of COPD. Perhaps because of the observational and counterintuitive nature of the evidence surrounding the issue, it seems that many patients still get suboptimal and possibly harmful care.
Paramedics helping people with acute exacerbations of COPD standardly treat patients with nebulised bronchodilators, corticosteroids, and oxygen. Oxygen can save lives by avoiding severely low