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Clinical Investigations: ASTHMA |

Effects of Short-term 28% and 100% Oxygen on Paco2 and Peak Expiratory Flow Rate in Acute Asthma*: A Randomized Trial

Gustavo J. Rodrigo; Mario Rodriquez Verde; Virginia Peregalli; Carlos Rodrigo
Author and Funding Information

*From the Departamento de Emergencia (Drs. G. Rodrigo and Peregalli), Hospital Central de las Fuerzas Armadas, Montevideo; Centro de Tratamiento Intensivo (Dr. Rodriguez Verde), Hospital de Paysandú, Paysandú; and Unidad de Cuidado Intensivo (Dr. C. Rodrigo), Asociación Española 1a de Socorros Mutuos, Montevideo, Uruguay.

Correspondence to: Gustavo J. Rodrigo, MD, Departamento de Emergencia, Hospital Central de las Fuerzas Armadas. Av. 8 de Octubre 3020, Montevideo 11600, Uruguay; e-mail: gurodrig@adinet.com.uy



Chest. 2003;124(4):1312-1317. doi:10.1378/chest.124.4.1312
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Study objective: We conducted the first randomized controlled study to assess the effects of short-term 28% and 100% oxygen on Paco2 and peak expiratory flow rate (PEFR) in patients with acute severe asthma.

Patients and interventions: Seventy-four patients (mean age, 37.9 ± 9.7 years [± SD]; PEFR, 41.0 ± 12.1% of predicted) from two emergency departments were randomized to receive 28% or 100% oxygen during 20 min.

Results: The administration of 100% oxygen significantly increases Paco2 (p = 0.03) and decreases PEFR (p = 0.001) as compared with administration of 28% oxygen. Paco2 before and during oxygen administration correlated significantly (p = 0.001) in both groups. Patients breathing 28% oxygen experienced a Paco2 fall; on the contrary, patients who received 100% oxygen showed an increase in Paco2, particularly those with Paco2 before oxygen treatment > 40 mm Hg.

Conclusions: This study confirmed previous observations that oxygen dose should be variable and based on achieving and maintaining target arterial oxygen saturation measured by pulse oximetry ≥ 92% rather than on prescribing predetermined concentrations or flow rates of inspired oxygen.

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