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March 13, 1972

Treatment of Respiratory Acidosis in Chronic Obstructive Lung Disease

JAMA. 1972;219(11):1477. doi:10.1001/jama.1972.03190370067021

To the Editor.—  The paper by Kettel and colleagues (217:1503, 1971) is welcome support for the spread of this practice. I would, however, like to comment on the experience reported and on some of the remarks about oxygen therapy explicitly or implicitly attributed to me.In Fig 1, the authors show the pH and carbon dioxide pressure (Pco2) values in these 87 episodes at the time of lowest pH, which in most patients was the "admission of diagnostic value." In 31, the Pco2 values were over 90 mm Hg. McNicol and I1 explained that such values can be achieved only in the presence of oxygen, and McNicol found that the true admission values were always less than 90 mm Hg. The patients described by Kettel et al, therefore, must either have been living on oxygen or they must have received excessive oxygen in the hour or three