During oxygen therapy for an acute COPD exacerbation, what SpO2 target is recommended?

• A. 95–100%
• B. 88–92%
• C. 92–96%
• D. 85–90%

Answer: (B)

In acute COPD exacerbation, the oxygen target is kept in a narrow range to balance providing enough oxygen with avoiding CO2 retention. Many COPD patients have chronic CO2 retention, and giving too much oxygen can blunt their hypoxic drive and worsen hypercapnia, leading to respiratory acidosis. Therefore, aiming for a low-to-moderate SpO2, specifically 88–92%, helps ensure tissues stay well-oxygenated without driving CO2 levels higher. If SpO2 falls below this range, oxygen should be increased modestly; if it rises above it, oxygen should be reduced to stay within the 88–92% window. This approach aligns with COPD management guidelines and is routinely used during acute exacerbations to prevent hypercapnic deterioration.