OXYGEN THERAPY

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OXYGEN THERAPY

• Oyewole Deboye O.

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• Introduction
• Conditions for oxygen therapy
• Administration
• Monitoring
• Side effects
• Conclusion

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• Oxygen therapy is the administration of oxygen as
  a medical intervention, which can be for a
  variety of purposes in both chronic and acute
  patient care
• Oxygen is essential for cell metabolism
• Room air contains 21 oxygen
• Delivery of oxygen to tissues depends on
• Inspired oxygen conc.
• Alveolar ventilation
• Ventilation-perfusion distribution within the
  lungs

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• 4. Hb conc.
• Conc. of CO
• Cardiac output
• Distribution of capillary blood flow within the
  tissues
• Oxygen levels in the blood can be helpful or
  damaging

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Conditions for oxygen therapy

• ACUTE CONDITIONS in emergency medicine
• Resuscitation
• Documented hypoxia
• Severe respiratory distress (acute asthma or
  pneumonia)
• Shock
• Cor pulmonale
• Acute myocardial infarction
• Severe trauma

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• Pulmonary HTN
• Major hemorrhage
• Convulsion
• Hypothermia
• As home therapy to abort cluster headache
  attacks,due to its vasoconstrictive effect
• Used as a drug delivery route as nebulizer mask
  for delivery of Salbutamol or Epinephrine

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• CHRONIC CONDITIONS
• COPD
• Lung fibrosis
• Sleep apnoea
• Kyphoscoliosis
• Myopaties/muscular dystrophy
• Brain stem lession
• Right-to-left shunts

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ADMINISTRATION

• Source Pressure regulator
  flow meter(preset or selective)L/min
• Supplemental oxygen
• Nasal cannulae 3-6LPM, delivering 02 conc of
  24-40
• Simple face mask 5-15LPM, delivering 02 conc of
  28-50
• Venturi mask 1-2LPM, delivering 02 conc of 24-28

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• HIGH CONC (40-60) 02 via high flow mask are
  particularly useful in acute type I respiratory
  failure because respiratory drive is high, such
  as acute asthma,pneumonia,pul. edema,pulmonary
  embolus,ARDS.when used for prolonged periods,it
  should be humified by passing over warm water
• LOW CONC (Venturi masks 24-28) are particularly
  useful in delivering controlled 02 therapy in
  type II respiratory failure.02 delivery through a
  nasal cannulae vary depending on minute
  ventilation,nasal blockage,and tendency to
  mouth-breath.humidification is not necessary as a
  high proportion of atmospheric air is mixed with
  02

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• In COPD, and type II respiratory failure,patient
  develop an abnormal tolerance to raised CO2 and
  may become dependent on hypoxic drive to
  breathe.In these patients, lower 02 conc is
  needed to avoid precipitating worsening
  respiratory depression.
• Positive pressure delivery system is used in
  patient who are unable to breathe on their
  own.use of AMBU bag,Resuscitator used in surgery
  with anaesthetic machines.

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MONITORING

• In patient with acute respiratory failure, close
  monitoring is essential and aterial bld gases
  taken on presentation should be repeated within
  20min to establish that tx has achieved
  acceptable Pa02 levels ? 7kPa(55mmHg) or 02
  saturation ? 88

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SIDE EFFECTS

• Vasoconstrictive effect on the circulatory system
• May increase the effect of stroke
• Seizures
• In infants,may cause blindness(promoting
  overgrowth of bld vessels in the eye obstructing
  sight.this is retinopathy of prematurity.
• Also in infant, it may contribute to construction
  of a ductus ateriosus

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• In adult,pulmonary 02 toxicity manifested by
  pulmonary oedema and free radical damage leading
  to fibrosis.
• Administration of high levels of 02 in patient
  with type II respiratory failure which reduces
  respiratory drive precipitating respiratory
  failure and can lead to death
• RISK OF FIRE!!!

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CONCLUSION

• Oxygen is essential for cell metabolism, and in
  turn, tissue oxygenation is essential for all
  normal physiologic functions.
• Prompt recognition of life threatening situations
  and immediate administration of oxygen
  appriopriately will benefit the patient in
  reducing morbidity and mortality.

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• Thank you for listening