We recommend a single rule for all patients with COPD, irrespective of the presence or absence of hypercapnia: oxygen saturations of 88%–92%. Widespread adoption of these target saturations from ambulance pick-up should simplify clinical pathways and reduce risk of excess oxygenation and death of patients with COPD.
For most COPD patients, a target saturation range of 88%–92% will avoid the risks of hypoxia and hypercapnia. Some patients with previous episodes of respiratory acidosis may require an "oxygen alert card" with a lower (personalized) target saturation range.
If it shows your forced expiratory volume (FEV1) is between 30% and 49%, you're in stage III. You may get other tests to help guide your treatment. For example, checking the oxygen level in your blood might show that oxygen therapy could help you.
When you have COPD, shortness of breath (and other symptoms, such as coughing) are an important measure of your current health status. However, knowing your saturation level is also important. And, unfortunately, it is entirely possible to be short of breath, but have healthy oxygen saturation.
When COPD gets worse it is called an exacerbation (ex-zass-er-BAY-shun). During an exacerbation you may suddenly feel short of breath, or your cough may get worse. You may also cough up phlegm, and it may be thicker than normal or an unusual color.
Shortness of breath does not equal saturation (SaO2%)
In other words, your level of dyspnea, or air hunger, does not always correlate with your oxygen saturation. This means that you can be short of breath, even extremely short of breath, even in the presence of normal oxygen saturation.
Respiratory failure is considered the major cause of death in advanced COPD.
Fatigue is the second most common symptom in patients with chronic obstructive pulmonary disease (COPD). Despite its high prevalence, fatigue is often ignored in daily practice.
Your physician will determine your stage based on results from a breathing test called a spirometry, which assesses lung function by measuring how much air you can breathe in and out and how quickly and easily you can exhale. They will also consider the severity of your symptoms and the frequency of flare-ups.
The 5-year life expectancy for people with COPD ranges from 40% to 70%, depending on disease severity. This means that 5 years after diagnosis 40 to 70 out of 100 people will be alive. For severe COPD, the 2-year survival rate is just 50%.
For patients with COPD, insufficient respiratory effort and/or inadequate alveolar ventilation, in a setting of uncontrolled oxygen delivery (where the precise Fio2 is unknown) can result in dangerous levels of both oxygen and carbon dioxide.
Between 88% and 92% oxygen level is considered safe for someone with moderate to severe COPD. Oxygen levels below 88% become dangerous, and you should ring your doctor if it drops below that. If oxygen levels dip to 84% or below, go to the hospital.
Long-term oxygen therapy is used for COPD if you have very low levels of oxygen in your blood (hypoxemia). It can help you breathe better and live longer. Long-term oxygen therapy should be used for at least 15 hours a day with as few interruptions as possible.
Signs of low oxygen levels
Severe shortness of breath, even while resting, but definitely with activity. Waking up while sleeping feeling short of breath. A feeling that you're choking. Bluish tinge to your lips, skin and/or fingernail beds.
As a person approaches the end of life, they may experience the following: Shortness of breath while resting. Trouble with activities of daily living: walking, cooking, dressing, or doing other daily activities. Chronic respiratory failure.
Which has worse symptoms? Because emphysema is a late stage of COPD, the signs and symptoms are similar. If you have emphysema, you are already experiencing COPD symptoms, though earlier stages of COPD will not have as dramatic an impact as the degree of tissue degeneration is minimal.
Although COPD is terminal, people may not always die of the condition directly, or of oxygen deprivation. Some people with COPD have other medical conditions, particularly cardiovascular disease. In fact, within 5 years of diagnosis, COPD is also an independent risk factor for sudden cardiac death.
Pace yourself and balance your activities with rest. Avoid heavy lifting, pushing heavy objects, and chores such as raking, shoveling, mowing, scrubbing. When lifting any object, exhale while lifting. Chores around the house might sometimes be tiring, so ask for help.
Walking is a safe and effective form of exercise for nearly everyone, including people living with chronic obstructive pulmonary disease (COPD).
Below 88% becomes dangerous, and when it dips to 84% or below, it's time to go to the hospital. Around 80% and lower is dangerous for your vital organs, so you should be treated right away.
Most pulse oximeters are accurate to within 2% to 4% of the actual blood oxygen saturation level. This means that a pulse oximeter reading may be anywhere from 2% to 4% higher or lower than the actual oxygen level in arterial blood.
Use Pursed Lip Breathing when walking. Inhale through your nose and exhale through pursed lips. Exhale slowly and comfortably, not forcibly, breathing out twice as long as you breath in. This will keep your breathing slow and restore oxygen to your body more rapidly.