What is the recommended target oxygen saturation (SpO2) for COPD exacerbations requiring hospitalization?

• A. 88–92%
• B. 96–100%
• C. 92–96%
• D. 90–95%

Answer: (A)

In COPD, especially during a hospitalization for an acute exacerbation, the goal of supplemental oxygen is to correct low oxygen levels without triggering CO2 retention. Many patients with chronic hypercapnia rely on a low-oxygen drive, so giving oxygen too aggressively can blunt their breathing and raise carbon dioxide, risking respiratory acidosis. Therefore the safest and most widely recommended target is a slightly lower, “low-normal” range: about 88–92% SpO2. This range provides adequate tissue oxygenation while minimizing the chance of oxygen-induced hypercapnia.

Higher targets, such as 96–100%, can push PaCO2 up and worsen acidosis. Slightly higher mid-ranges (like 92–96% or 90–95%) may be used in patients without CO2 retention or in different clinical scenarios, but for COPD exacerbations requiring hospitalization, 88–92% is the preferred target to balance oxygenation with safety. Monitor the patient and adjust as needed based on symptoms and, if available, arterial blood gas results.