Nuts and Bolts of Oxygen Therapy

1
Nuts and Bolts of Oxygen Therapy

• Ed Corazalla MS, RPFT
• Scientist/Pulmonary Lab Manager
• University of Minnesota

2
Air
University of Minnesota
3
O2 Safety -- Video

• Its not good--to blow things up!

University of Minnesota
4
O2 Safety

• Oxygen is NOT an explosive gas
• High 02 levels make things more flammable.
• Store oxygen equipment in well ventilated areas,
  not near heat sources or open flames. (hot water
  heaters, furnace, stoves.)
• NO smoking within 10 feet of Oxygen.
• Never use oil/grease/alcohol based products on 02
  equipment
• No petroleum based products on your face when
  using 02 (Vaseline, Vicks, AD ointment) use
  water based products

• ----------------------------------------------Univ
  ersity of Minnesota

5
Benefits of using Oxygen.

• Longer life
• Improved quality of life
• Increased Stamina and Exercise Tolerance
• Improved Memory
• Clearer Thinking
• More Restful Sleep
• Studies have shown failure to use oxygen as
  prescribed--will result in stress to the heart
  and shorter life expectancy.

University of Minnesota
6
(No Transcript)
7
Terminology/Symbols

• Hypoxemia, Hypoxia
• Dyspnea, Apnea
• O2 Oxygen C02 Carbon Dioxide
• Oxygen Saturation/Desaturation
• C02 Retainer
• CPAP, BI-PAP

University of Minnesota
8
Why we breathe O2 Fuel CO2 H20 Energy

• O2 is used and CO2 is produced in every cell in
  the body.
• The lungs extract O2 from the air and exhale CO2
  produced by the body.
• The balance of O2 consumed and CO2 produced is
  what drives our breathing.
• If the lungs are not working well this balance is
  disrupted.

University of Minnesota
9
Reasons People Need Oxygen Therapy
COPD --Chronic Obstructive Pulmonary Disease.
Which includes emphysema, chronic bronchitis and
Alpha-1-Antitrypsin (A1AD). Pulmonary Fibrosis
(Restrictive lung disease) OSA--Obstructive
Sleep Apnea CHF--Congestive Heart Failure (heart
disease) Neuromuscular disease
University of Minnesota
10
Why Oxygen is needed in Pulmonary
Fibrosis/Interstitial lung disease? Scaring of
the lung can cause

• Reduced Vital Capacity (Spirometry)
• Smaller lungs less surface area for O2
  exchange.
• Reduced Diffusion Capacity (DLCO)
• Lungs are less efficient.
• Less 02 is exchanged per breath
• Reduced exercise tolerance
• 6 minute walk tests
• Oxygen Desaturation tests
• Measured in the Pulmonary Function Lab (PFTs)

11
(No Transcript)
12
                                                
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                  
13
(No Transcript)
14
(No Transcript)
15
(No Transcript)
16
Because youre S.O.B.?Not Necessarily?

• Why do I need oxygen (O2) ??

University of Minnesota
17
Sign and Symptoms
Shortness Of Breath (SOB) Dyspnea On Exertion
(DOE) Breathing hard and fast. Racing or
pounding heart Speaking in broken or choppy
sentences Cyanosis Purplish/blue color changes
in lips and finger nails. Some people have no
symptoms at all!
University of Minnesota
18
How do we know you need 0xygen?

• ABG Arterial Blood Gas
• Measure gases in blood O2, CO2, pH
• CO2 retainers
• Oximetry
• Measures oxygen levels in your bloodsaturation

University of Minnesota
19
How do we know you need 0xygen?

• 6 minute walk test
• Exercise Tests
• De-saturation studies

University of Minnesota
20
When is oxygen is needed?

• Oxygen is prescribed when your oxygen level
  drops below a certain point (usually lt89 on
  pulse oximetry - clip on your finger)
• Or a PO2 lt 60 on an arterial blood gas - sample
  of blood from an artery.

21
Untreated Hypoxia(low oxygen levels)Can Lead
To

• Cor pulmonale (right heart disease)
• Decreased cognitive function.
• Reduced quality of sleep
• Muscle fatigue
• Decreased exercise tolerance
• Chronic fatigue
• Increased pulmonary artery pressures

University of Minnesota
22
Goal of Oxygen Therapy

• To maintain adequate tissue oxygenation while
  minizing cardiopulmonary work

University of Minnesota
23
Ways to Store/Process O2

• O2 Cylinders (Compressed gas tanks)
• Gas under high pressure
• Green (sizes B,D,E,H)
• Concentrators
• O2 is concentrated out of the air

University of Minnesota
24
Ways to Store/Process O2

• Liquid O2
• -300F O2 gas becomes a liquid
• Volume of O2 decreases 800 to 1
• Storage can be smaller/lighter/more portable

University of Minnesota
25
Delivery of O2

• Continuous Flow
• Flow is constant at a set rate (Liters/minute)
• More O2 is delivered/minute.
• Better for high demand times (exercise) or for
  people who have very advanced disease.
• Conserving Devices (demand valve)
• Conserves O2 (uses less/minute)
• O2 is delivered on the inspiration only.
• Storage containers can be smaller/lighter/more
  portable

University of Minnesota
26
Nasal Cannula
27
Cylinder DurationCylinder Pressure(PSI) x
Conversion Factor Minutes The Tank Will Last
Flow Setting(L/Min)
Example New (Full 2200psi ) E cylinder at Flow
Rate 2 L/min. 2200 x 0.28/2 Liters per min
308 Minutes or 308/60 5.13 hrs
28
Flying with O2

• You will not be able to use your own O2
• Charges range from 50-150 for each leg of the
  trip
• So -- Fly non-stop! Or you pay every stop
• Call at least a month ahead.
• Most Airlines you can carry empty tanks/liquid
  systems in your baggage
• Have Oxygen supplier meet you at the airport.
• www.oxygen4travel.com/tips
• www.homeoxygen.org

29
Can I get addicted to Oxygen?

• Will wearing Oxygen make my
• lungs weaker?
• Can too much O2 be bad?

University of Minnesota