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Sunday, December 21, 2014
COPD (Chronic Obstructive Pulmonary Disease)
Question About Dying From This
My father has emphysema. He was given six months by his doctor and has been sent home with hospice care. His oxygen levels are around 84% with oxygen. How low do his O2 levels get when death occurs? When his levels are low enough to kill him will he be aware enough to know what is happening? Could you explain the process before death to me? Thanks!
There are several issues that can impact your father's disease course.
1) His low oxygen levels do not damage the lungs (they are already damaged). The low oxygen damages the heart and the brain as these are the organs that use the most oxygen. When your father's blood oxygen level is low, the blood vessels in the lung contract. (I know this is counterintuitive, but the body does this to protect against gases that may be present such as carbon monoxide.) When the blood vessels in the lungs contract, this is called pulmonary hypertension.
2) Death in end-stage COPD is usually related to heart failure or some type of brain issue (see #1). Symptoms can be significant; however, if dyspnea (shortness of breath) is an issue, the use of morphine IV can reduce dyspnea at this stage to make the patient comfortable. The goal would be to maintain your father's comfort with all available methods--please speak to your hospice team about this--these professionals are extremely knowledgeable about managing symptoms at the end of life.
3) You may wish to speak with your father's doctor and hospice team regarding his low oxygen levels. Perhaps his oxygen delivery system needs to be increased to a face mask or transtracheal oxygen.
You may also find the following guidelines helpful in knowing what to expect:
Emphysema: Stages and Life Expectancy
I wish you and your father the best at this difficult time.
Gerene S Bauldoff, RN, PhD, FCCP, FAACVPR, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University