Treatment of Respiratory Acidosis in Chronic Obstructive Pulmonary Disease (COPD)

Respiratory acidosis occurring in a patient with chronic obstructive pulmonary disease (COPD) requires a management approach shaped by the specific physiology of obstructive lung disease. Standard assumptions about oxygenation targets and treatment intensity do not apply directly in this population.

In patients with COPD and emphysema, the characteristic physiological changes of the disease mean that pulse oximetry saturations are typically lower than in the general population — around 88%–92%. This alters how oxygenation is managed: both under-supplementation and over-supplementation carry distinct clinical risks in this group.

Oxygenation management targeting a specific saturation range is central to this protocol, with careful attention to avoiding over-supplementation. The approach also includes therapy directed at the underlying airway obstruction. The complete structured regimen — including agent selection, sequencing, and monitoring criteria — is available in the full protocol.