Who may be at risk for CO2 retention when receiving oxygen therapy?

Patients with chronic obstructive pulmonary disease (COPD) are at risk for CO2 retention when receiving oxygen therapy due to the way their bodies manage carbon dioxide (CO2) levels. In individuals with COPD, the lungs experience compromised air flow and gas exchange, which leads to a chronically elevated level of carbon dioxide in the bloodstream—a condition known as hypercapnia.

Many COPD patients have developed a reliance on low oxygen levels to stimulate their breathing reflex due to a condition called hypoxic drive. When these patients receive supplemental oxygen, it can inadvertently increase their oxygen saturation, potentially diminishing their respiratory drive and, as a result, they may retain more CO2. This retention occurs because the strong stimulus for breathing provided by low oxygen levels is reduced, leading to inadequate ventilation and consequently elevated CO2 levels.

In contrast, patients with heart disease may have respiratory difficulties, but they do not inherently have the same issues with CO2 retention as those with COPD. Healthy adults, by definition, typically do not face such risks when undergoing oxygen therapy, as their respiratory systems function correctly. Patients in acute respiratory distress may experience respiratory failure and require support, but they are managed with careful monitoring and adjustments to therapy, reducing the likelihood of CO2 retention compared to those