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VOLUME 12 , ISSUE 1 ( January-March, 2017 ) > List of Articles

REVIEW ARTICLE

COPD with hypoxemia- CPAP, LTOT, NIV-When How What: Review

Citation Information : COPD with hypoxemia- CPAP, LTOT, NIV-When How What: Review. Indian Sleep Med 2017; 12 (1):5-11.

DOI: 10.5958/0974-0155.2017.00002.X

License: NA

Published Online: 01-12-2014

Copyright Statement:  NA


Abstract

Daytime hypoxemia in chronic obstructive pulmonary disease (COPD) patients is common. The causes of daytime hypoxemia are varied and are linked to nocturnal breathing disorders. These nocturnal breathing disorders of COPD are: 1) obstructive sleep apnoea (OSA), 2) nocturnal oxygen desaturation (NOD) without CO2 retention and 3) nocturnal hypoventilation. OSA with COPD i.e. overlap syndrome is seen in overweight rather than obese patients. They do not have excessive daytime sleepiness unlike OSA alone hence it is easily missed. Continuous positive airway pressure (CPAP) is the treatment of choice in these patients. Nocturnal oxygen desaturation without CO2 retention is due to V/Q mismatch and is seen in those with respiratory COPD phenotype. Long-term oxygen therapy (LTOT) alone is adequate for patients who develop consequent daytime hypoxemia. Contrarily, daytime hypoxemia due to nocturnal hypoventilation is seen in systemic COPD phenotype and it responds to non-invasive ventilator (NIV) with LTOT. This review is aimed at deciding if CPAP, LTOT or NIV with LTOT is required in COPD patients with daytime hypoxemia.

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