From the Guidelines
Coughing can lead to an increase in oxygen saturation levels by clearing secretions and improving airflow in the lungs, and this improvement should be maintained within the target saturation range of 94-98% for acutely ill patients not at risk of hypercapnic respiratory failure, as recommended by the BTS guideline for oxygen use in adults in healthcare and emergency settings 1. When a person coughs, they clear secretions or mucus from their airways, which can improve airflow and ventilation in the lungs. This improved airflow allows for better gas exchange, where oxygen enters the bloodstream more efficiently and carbon dioxide is removed. The forceful expiration during coughing also helps to recruit collapsed alveoli (tiny air sacs in the lungs), increasing the surface area available for oxygen transfer.
Key Considerations
- The target saturation range for patients with known chronic obstructive pulmonary disease (COPD) or other known risk factors for hypercapnic respiratory failure is 88-92% pending the availability of blood gas results, as suggested by the BTS guideline 1.
- Most non-hypoxaemic breathless patients do not benefit from oxygen therapy, but a sudden reduction of ≥3% in a patient’s oxygen saturation within the target saturation range should prompt fuller assessment of the patient, as stated in the BTS guideline 1.
- Fully conscious hypoxaemic patients should ideally be allowed to maintain the most upright posture possible, unless there are good reasons to immobilise the patient, in order to reduce oxygenation reduction in the supine position, as recommended by the BTS guideline 1.
Clinical Implications
- If you notice that your oxygen saturation improves after coughing, it suggests that airway clearance is beneficial for you, and regular deep breathing exercises, staying hydrated to keep secretions thin, and using techniques like huffing (forced expiration technique) can help maintain clear airways.
- However, if you frequently need to cough to maintain adequate oxygen levels, this should be discussed with a healthcare provider as it may indicate an underlying respiratory condition requiring treatment.
From the Research
Oxygen Saturation After Coughing
- Coughing can lead to temporary changes in oxygen saturation levels [ 2 ]
- According to the AARC Clinical Practice Guideline, the target oxygen saturation range for most hospitalized patients is 94-98% [ 2 ]
- For patients with COPD, the target range is 88-92% [ 2 ]
- The guideline does not specifically address the effect of coughing on oxygen saturation, but it emphasizes the importance of monitoring and maintaining optimal oxygenation targets [ 2 ]
- High-flow oxygen therapy may be beneficial in certain situations, such as postextubation or to avoid escalation to noninvasive ventilation [ 2 ]