Oxygen-induced hypercapnia in patients with exacerbations of chronic obstructive pulmonary disease: pathogenesis, diagnosis and prevention in emergency medical care (review)
https://doi.org/10.24884/2072-6716-2026-27-1-70-76
Abstract
The purpose of the study: conducting an analysis of periodical medical literature on the problem of the occurrence of oxygen-induced hypercapnia in patients with severe chronic and acute respiratory failure (RF) and its significance in providing emergency care to patients with chronic obstructive pulmonary disease (COPD).
Objectives of the study. 18 articles on the subject of the review were analyzed.
The results of the study. During emergency medical care (EMC), patients with respiratory failure are at risk of developing complications from oxygen therapy, such as increased blood carbon dioxide levels, which can significantly worsen the prognosis. This complication is particularly likely in severely ill patients with underlying hypercapnia associated with obstructive airway disease. Inappropriately high oxygen flow during inhalation plays a significant role in the development of this complication.
Conclusion. This analysis of literature may have practical importance for medical staff of ambulance brigades, as well as for physicians in hospital›s emergency room when providing medical care to patients with worsening bronchoobstructive diseases.
Keywords
oxygen therapy,
oxygen-induced hypercapnia,
upper airway obstructive diseases,
hypercapnic respiratory failure
Supporting agencies: the study had no sponsorship
About the Author
A. L. Ershov
North-Western State Medical University named after I.I. Mechnikov
Russian Federation
Russian Federation
Andrey L. Ershov
St. Petersburg
References
1. Sarkar M., Madabhavi I., Kadakol N. Oxygeninduced hypercapnia: physiological mechanisms and clinical implications // Monaldi Arch. Chest. Dis. 2022. Vol. 93, No 3. doi: 10.4081/monaldi.2022.2399.
2. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for diagnosis, management and prevention of chronic obstructive pulmonary disease (2023 report) // USA: Global Initiative for Chronic Obstructive Lung. Disease. 2023. Available: https://goldcopd.org/2023-gold-report.
3. MacIntyre N. R. Acute Hypercapnic Respiratory Failure in COPD // Respir. Care. 2023. Vol. l, No 7. P. 973–982. doi: 10.4187/respcare.10560.
4. Yetiskul E. et al. Oxygen overshoot: a case report navigating the perils of unsupervised supplementation in chronic obstructive pulmonary disease (COPD) // Cureus. 2023. Vol. 15, No 12. e50274. doi: 10.7759/cureus.50274.
5. Barach A. L. Recent advances in inhalation therapy in the treatment of cardiac and respiratory disease // NT State J. Med. 1937. Vol. 37. P. 1095–1110.
6. Echevarria C., Steer J., Wason J. et al. Oxygen therapy and inpatient mortality in COPD exacerbation // Emerg. Med. J. 2021. Vol. 38. P. 170–177.
7. Ilinykh E. I., Korelina A. I. Problems of oxygeninduced hypercapnia in patients with respiratory failure. Bulletin of Syktyvkar University. Series 2: Natural Science. Medicine, 2024, No 1, рр. 37– 44 (In Russ.). https://doi.org/10.34130/2306–6229–2024–1–37.
8. Abdo W.F., Heunks L. M. Oxygen-i nduced hypercapnia in COPD: myths and facts // Crit. Care. 2012. Vol. 16, No 5. P. 323. doi: 10.1186/cc11475.
9. Campbell E. J. Respiratory failure: the relation between oxygen concentrations of inspired air and arterial blood // Lancet. 1960. No. 2. P. 10–11.
10. Christiansen J., Douglas C. G., Haldane J. S. The absorption and dissociation of carbon dioxide by human blood // J. Physiol. 1914. Vol. 48. P. 244–271.
11. Weatherall M., Beasley R. The effect of 50% oxygen on PtCO2 in patients with stable COPD, bronchiectasis, and neuromuscular disease or kyphoscoliosis: randomised cross-over trials // BMC Pulm. Med. 2020. Vol. 20, No 1. P. 125. doi: 10.1186/s12890-020-1132-z.
12. Seery J. P. HighDose Oxygen Therapy and Acute Hypercapnia in Elderly Patients: A Case Series Analysis // Am. J. Case Rep. 2024. Nov. 12. Vol. 25. e945044. doi: 10.12659/AJCR.945044.
13. Johnson J.E., Peacock M. D., Hayes J. A. et al. Forced expiratory flow is reduced by 100% oxygen in patients with chronic obstructive pulmonary disease // South Med. J. 1995. Vol. 88. Р. 443–449.
14. Drechsler M., Morris J. Carbon Dioxide Narcosis // 2023. Jan 9 // StatPearls [Internet]. Treasure Island (FL). StatPearls Publishing, 2025. Jan. PMID: 31869084.
15. Rawat D., Modi P., Sharma S. Hypercapnea. [Updated 2023 Jul 24] // StatPearls [Internet]. Treasure Island (FL). StatPearls Publishing, 2025. Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500012.
16. Kedia Y.S., Rathi V., Ish P., Gupta N., Kumar R. Chronic Obstructive Pulmonary Disease and Oxygen Therapy: A Doubleedged Sword // J. Assoc. Physicians India. 2024. No. 6. P. 87–90. doi: 10.59556/japi.72.0568.
17. Beasley R. et al. Thoracic Society of Australia and New Zealand oxygen guidelines for acute oxygen use in adults: Swimming between the flags // Respirology. 2015. Vol. 20. P. 1182–1191. doi: 10.1111/resp.12620.
Review
For citations:
Ershov A.L. Oxygen-induced hypercapnia in patients with exacerbations of chronic obstructive pulmonary disease: pathogenesis, diagnosis and prevention in emergency medical care (review). EMERGENCY MEDICAL CARE. 2026;27(1):70-76. (In Russ.) https://doi.org/10.24884/2072-6716-2026-27-1-70-76
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