Effect of various modes of oxygen administration on the arterial gas values in patients with respiratory acidosis

Abstract

The need to correct hypoxia and hypoxaemia in patients with respiratory acidosis is well accepted. However, the proper mode of oxygen administration is debated. We have evaluated various modes of oxygen administration by studying arterial gas values in 15 patients with respiratory acidosis before, during, and after oxygen administration. The subjects were divided into three groups. Group A received pure oxygen by mask for 10 minutes: group B received oxygen by nasal catheter at one to two litres per minute for 10 minutes; group C received oxygen as did group B but for between 150 and 240 minutes. Intermittent oxygen administration does not correct hypoxaemia for any appreciable length of time. Furthermore. it is often followed by hypoxaemia more pronounced than before therapy. Increased carbondioxide tension occurred in all patients and frequently remained present after the oxygen tension had fallen to baseline levels. Continuous oxygen administration by nasal catheter resulted in a sustained improvement of the oxygen tension. However, serious worsening of acidosis took place in two subjects. We feel that intermittent oxygen therapy has little place in the treatment of respiratory acidosis. Irrespective of the mode of administration, when oxygen is administered to patients with respiratory acidosis it should be giyen with a mechanical respirator or pharmacological stimulant to ensure continued alveolar ventilation. © 1962, British Medical Journal Publishing Group. All rights reserved.