In which patient population is respiratory arrest a potential complication of high concentration oxygen administration?

High concentration oxygen administration poses a risk of respiratory arrest primarily in patients with chronic obstructive pulmonary disease (COPD). This occurs because many COPD patients have adapted to lower levels of oxygen in their blood due to chronic hypoxemia. They rely on this hypoxic drive to stimulate their respiratory drive. When high concentrations of oxygen are administered, it can lead to a reduction in their respiratory drive, resulting in elevated carbon dioxide levels and potential respiratory failure. This is known as oxygen-induced hypercapnia.

In contrast, other patient populations, such as stroke victims or cardiac patients, do not typically experience the same risk with oxygen therapy, as their respiratory drive is usually not impaired in the same way. Children, while also sensitive to changes in oxygen levels, do not have the same chronic adaptations that COPD patients have. Therefore, administering high concentrations of oxygen is particularly problematic for COPD patients due to their unique physiological responses, making them the most at risk for respiratory arrest under these circumstances.