For patients with COPD, titrating oxygen to what range is common to reduce oxygen-induced risks?

• A. 88-92%, oxygen-induced hypercapnia and mortality
• B. 92-98%, hyperoxia and pneumonia
• C. 75-85%, dehydration and fatigue
• D. 90-95%, metabolic acidosis and arrhythmia

Answer: (A)

In COPD, oxygen is titrated to a narrow target range to balance keeping the blood well oxygenated with avoiding CO2 buildup. The common target is about 88-92% SpO2. This range helps prevent hypoxemia while reducing the risk that high oxygen levels will blunt ventilatory drive and worsen ventilation-perfusion mismatch, which can raise arterial CO2 (hypercapnia) and worsen outcomes. Giving oxygen too liberally can increase CO2 retention and mortality in COPD patients, so staying in this lower-to-moderate range is preferred. Very high saturation targets (near-normal ranges) can elevate the risk of oxygen-induced hypercapnia, while too low targets risk dangerous hypoxemia.