Tuesday, January 4, 2022

Blue Bloaters



Blue bloaters is the name used to describe COPD (chronic obstructive pulmonary disease) patients who are overweight, puffed up, having difficulty breathing, lacking oxygen (hence the blue, cyanotic discolouration) and have leg swelling due to right heart faillure.  COPD is mainly caused by cigarette smoking.

These patients are hypoxic with low oxygen saturation and some with carbon dioxide retention.  The brain adapts and is reliant on the low oxygen in the blood to drive breathing.  As such, an overdose of oxygen, removing the hypoxic drive, will make them worse leading ultimately to deeper respiratory failure, carbon dioxide narcosis, respiratory arrest and death. 

Therefore, it is very important for caregivers to know exactly how much oxygen (litres per minute) to give to these COPD patients.  Some of these patients may only need to maintain their SpO2 at only 90% to 93% as they are used to these low oxygen to drive ventilation and to "blow out" the carbon dioxide. 

Please consult your doctor for medical advice and not to give too much oxygen to these COPD patients.  Arterial blood gas analysis is required to make a proper diagnosis for these patients. 

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