From the Guidelines
The management of hypercapnic respiratory failure due to excessive oxygen therapy requires stepping down oxygen therapy to the lowest level necessary to maintain a saturation range of 88–92%. This approach is crucial to avoid life-threatening rebound hypoxaemia, which can occur with sudden cessation of supplementary oxygen therapy 1. The use of a Venturi mask or nasal cannulae with oxygen flow rates adjusted to achieve the target saturation range is recommended. For example, 28% or 24% oxygen from a Venturi mask or 1–2 L/min via nasal cannulae may be used, depending on oxygen saturation and subsequent blood gas measurements 1.
Key considerations in managing hypercapnic respiratory failure include:
- Avoiding excessive oxygen therapy to prevent worsening hypercapnia
- Monitoring oxygen saturation and blood gas measurements to guide oxygen therapy adjustments
- Using non-invasive ventilation (NIV) or other supportive therapies as needed to manage respiratory failure
- Considering the use of high-flow nasal oxygen (HFNO) as an alternative to conventional oxygen therapy in selected patients 1
It is essential to prioritize the patient's oxygen saturation and blood gas measurements when adjusting oxygen therapy to minimize the risk of rebound hypoxaemia and optimize outcomes. The British Thoracic Society guideline for oxygen use in adults in healthcare and emergency settings provides a framework for managing hypercapnic respiratory failure due to excessive oxygen therapy 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Airsupra Overview
- Airsupra is a new asthma rescue inhaler that contains both albuterol and budesonide in a single inhaler 2, 3
- It is designed to treat acute asthma attacks by combining a short-acting β2-adrenergic agonist (albuterol) with a corticosteroid (budesonide) 3
Study Findings
- The MANDALA study, published in 2022, looked at the efficacy and safety of Airsupra in adults and children aged ≥4 years with moderate-to-severe asthma 2, 4
- The study found that Airsupra can help control both bronchoconstriction and inflammation, and reduce the risk of asthma exacerbations 2, 4
- Patients should not stop their asthma maintenance therapy when Airsupra is prescribed 3
Relevant Studies
- The MANDALA study was designed to determine the efficacy of albuterol in combination with budesonide versus albuterol as rescue therapy in adult, adolescent, and pediatric patients with moderate-to-severe asthma 4
- Other studies have looked at the use of supplemental oxygen therapy in patients with chronic obstructive pulmonary disease (COPD), but these are not directly related to Airsupra 5, 6