The hypoxic drive is a form of respiratory drive in which the body uses oxygen chemoreceptors instead of carbon dioxide receptors to regulate the respiratory cycle.

Normal respiration is driven mostly by the levels of carbon dioxide in the arteries, which are detected by peripheral chemoreceptors, and very little by the oxygen levels. An increase in carbon dioxide will cause chemoreceptor reflexes to trigger an increase in respirations.

However in cases where there are chronically high carbon dioxide levels in the blood such as in COPD patients, the body will begin to rely more on the oxygen receptors and less on the carbon dioxide receptors. In this case, when there is an increase in oxygen levels, the body will decrease the respirations.

If a person with chronic hypoxic drive enters acute respiratory distress, healthcare providers who are unaware of their condition may provide oxygen therapy as an initial treatment. The reaction to increased oxygen causes the oxygen receptors to decrease respirations, possibly to the point of respiratory arrest. For this reason, people with hypoxic drive must not receive oxygen in high concentrations or for long periods. Treatment of a patient in acute respiratory distress with hypoxic drive can still be given oxygen therapy, however to avoid having the situation deteriorate to full respiratory arrest, arterial blood gas levels should be closely monitored via pulse oximetry and respirations should also be closely monitored.