DISCUSSION
We found that oxygen treatment, titrated by paramedics to achieve arterial oxygen saturations between
88% and 92%, for patients with breathlessness and a
history or risk of chronic obstructive pulmonary disease, reduced the risk of death from respiratory failure
by 58% for all patients and 78% for patients with confirmed chronic obstructive pulmonary disease, compared with high flow oxygen. For high flow oxygen
treatment in patients with confirmed chronic obstructive pulmonary disease in the prehospital setting, the
number needed to harm was 14; that is, for every 14
patients who are given high flow oxygen, one will die.
Patients with chronic obstructive pulmonary disease
who received titrated oxygen according to the protocol
were also significantly less likely to have respiratory
acidosis or hypercapnia.