I just received this information from a world renowned expert in COPD, Dr. Mark Magnus. BSRC, RRT, RPFT, FAARC
San Antonio, TX
"Hypercapnic Respiratory Failure" is INDEED a bonafide and legitimate condition. It is the term for respiratory failure - indeed, "acute" respiratory failure (abbreviated "ARF") characterized by a blood carbon dioxide level that exceeds the upper normal limit. There is also another term for ARF called "Hypoxemic Respiratory Failure". It means acute respiratory failure that is characterized by a blood oxygen level that is below the lower limit of normal. Then there is the term which combines both hypoxemic and hypercapnic respiratory failure. But, most often we just say ARF and be done with it. Depending upon where the clinician resides depends upon their preferred characterization and the term or label they use. It is also a matter of context - with whom the discussion is being had or written piece is targeting - which of the various terms the speaker or author chooses to use.
No one is denying those facts. What you find strongly disputed is the suggestion within that article it is stated that using too much oxygen can in ANY WAY influence or "cause" the onset or worsening of (on-coming or already established) hypercapneic respiratory failure. That question has been a source of great debate for literally decades, having been the brain child a misbegotten theory put forth by a physician (Dr E. J. Campbell) back in the 1950's and '60's, when understanding of the causes of ARF were being formulated and were in a very early and crude state of development.
As to how it 'affects' those of you who have progressed to a severe stage of COPD, where you now retain CO2 and exhibit "compensation" in your blood gases for having the presence of excess CO2 in your blood, that erroneous theory has played - and continues to play - an important role in how your physician and other health care professionals treat you with regard to administration of your oxygen therapy. The end result is that a myriad of patients have gone to an early grave because subscribers to the theory have - in practice - withheld adequately therapeutic oxygen supplementation from them, causing avoidable worsening of and ill effects of hypoxemia on their disease state to occur at a more rapid rate and earlier point in their disease process.
Today, most groups within the pulmonary medical community are shifting their consideration of application of supplemental oxygen therapy to target more adequate correction of hypoxemia, a goal that has increasingly proven to not only improve momentary difficulties caused by hypoxemia, but also to improve overall outcomes and survival with folks' disease. Still - and most frequently found - the British, Australian and New Zealand - pulmonary treatment approaches subscribe to the misbegotten theory and continue to publish and press the validity of the theory, worse yet, based upon nothing more than misinterpreted anecdotal evidence - NOT ANY 'empirical' evidence. (Empirical evidence is that which can be definitively observed, produced, re-produced and shown a have a provable "cause and effect" relationship.)
As to what you should do as a patient, if you have hypoxemia, current wisdom is that you should do your best to correct that hypoxemia, using enough oxygen to raise your blood levels to a saturation that is above 90 %. Also, it is NOT going to hurt you to have a blood oxygen level that is 95%, 96 or greater. More importantly, having a "normal" or high normal blood oxygen level will NOT - WILL NEVER - cause you to breathe ineffectively or to somehow "lose" your ability to breathe simply by being that high!"
