WHAT IS ALREADY KNOWN ON THIS TOPIC
Audits have shown increased mortality, acidosis, and hypercarbia in patients with acute
exacerbations of chronic obstructive pulmonary disease treated with high flow oxygen
High flow oxygen is still used routinely in prehospital and hospital areas for breathless
patients with chronic obstructive pulmonary disease
A “more is better” oxygen culture is strong in prehospital management
WHAT THIS STUDY ADDS
Titrated oxygen treatment reduces mortality, acidosis, and hypercarbia in patients with acute
exacerbation of chronic obstructive pulmonary disease treated before arrival at hospital
The risk of death was reduced by 78% by use of titrated oxygen rather than high flow oxygen,
with a number needed to harm of 14
These findings provide strong evidence that titrated oxygen treatment should be used for
hypoxic or breathless patients with chronic obstructive pulmonary disease in prehospital
setting