Oxygen Therapy: Increasing Blood Oxygen Saturation

• Oxygen therapy delivers oxygen to individuals with breathing-related conditions

Oxygen Therapy Basics

• The goal of oxygen therapy is to increase blood oxygen saturation
• Oxygen saturation is typically maintained above 90%
• Oxygen therapy can be administered in hospitals, clinics, and at home
• Oxygen delivery devices include nasal cannulas, masks, and ventilators
• Patient response monitoring is crucial for adjusting flow rate and delivery method

Indications for Oxygen Therapy

• Hypoxemia indicates low levels of oxygen in the blood
• Respiratory distress indicates difficulty breathing or shortness of breath
• Cyanosis indicates bluish discoloration of the skin resulting from poor circulation or inadequate blood oxygenation
• Pneumonia is a lung infection causing inflammation and fluid buildup in the air sacs
• Asthma is a chronic respiratory disease causing inflammation and narrowing of airways
• Chronic obstructive pulmonary disease (COPD) is a progressive lung disease obstructing airflow from the lungs
• Heart failure is a condition where the heart cannot pump enough blood to meet the body’s needs
• Carbon monoxide poisoning is a dangerous condition caused by inhaling carbon monoxide gas

Oxygen Delivery Devices

• Nasal Cannula:
  • Delivers low-flow oxygen at 1 to 6 liters per minute (LPM)
  • Oxygen concentration (FiO2) is between 24% and 44%
• Simple Face Mask:
  • Delivers medium-flow oxygen at 5 to 10 LPM
  • FiO2 is between 35% and 55%
• Non-Rebreather Mask:
  • Delivers high-flow oxygen at 10 to 15 LPM
  • FiO2 is between 80% and 95%
  • Includes a reservoir bag for oxygen storage
• Venturi Mask:
  • Delivers precise oxygen concentrations using color-coded adapters to set the FiO2
  • Flow rates depend on the adapter and are suitable for patients with COPD
• High-Flow Nasal Cannula (HFNC):
  • Delivers heated and humidified oxygen at high flow rates, ranging from 15 to 60 LPM
  • Provides an FiO2 of 21% to 100%
  • Improves patient comfort and reduces the work of breathing
• Mechanical Ventilator:
  • Delivers oxygen and supports breathing for patients who cannot breathe adequately on their own
  • Used in critical care settings and requires intubation or tracheostomy

Monitoring Oxygen Therapy

• Pulse Oximetry:
  • A non-invasive method to measure oxygen saturation using a sensor on the finger or earlobe
  • Normal SpO2 range is typically 95% to 100%
  • The target SpO2 range for patients with certain conditions like COPD may be lower
• Arterial Blood Gas (ABG) Analysis:
  • An invasive method to measure blood oxygen levels, carbon dioxide levels, and pH through a blood sample taken from an artery
  • Provides a more accurate assessment of oxygenation and ventilation
• Clinical Assessment:
  • Monitoring includes the patient's respiratory rate, effort, and breath sounds
  • Assessing the patient's level of consciousness and overall condition
  • Observing for signs of respiratory distress

Potential Complications of Oxygen Therapy

• Oxygen Toxicity:
  • Can occur with prolonged exposure to high concentrations of oxygen causing damage to the lungs and other organs
  • Symptoms include cough, chest pain, and shortness of breath
• Absorption Atelectasis:
  • Occurs with high concentrations of oxygen cause nitrogen to be washed out of the alveoli which leads to alveolar collapse
• Mucous Membrane Drying:
  • Oxygen can dry out the mucous membranes in the nose and mouth, so humidification is often used to prevent this
• Fire Hazard:
  • Oxygen is a combustible gas, so precautions should be taken to prevent fires, especially around open flames and electrical equipment

Oxygen Therapy in Specific Conditions

• COPD:
  • Target SpO2 range is typically 88% to 92%
  • Venturi masks are often used to deliver precise oxygen concentrations
  • High-flow oxygen should be avoided to prevent carbon dioxide retention
• Asthma:
  • Oxygen therapy is used to treat hypoxemia during asthma exacerbations
  • The goal is to maintain SpO2 above 90%
  • Beta-agonists and corticosteroids are also used to treat asthma
• Pneumonia:
  • Oxygen therapy is used to treat hypoxemia caused by pneumonia
  • The goal is to maintain SpO2 above 90%
  • Antibiotics are used to treat bacterial pneumonia
• Heart Failure:
  • Oxygen therapy is used to improve oxygenation and reduce the work of breathing
  • The goal is to maintain SpO2 above 90%
  • Diuretics and other medications are used to manage heart failure

Special Considerations

• Pediatric Patients: children require careful monitoring and adjustments based on age and size during oxygen therapy
• Geriatric Patients: elderly individuals may have decreased respiratory function, so careful assessment and monitoring during oxygen therapy is important
• Home Oxygen Therapy: education on equipment use, safety precautions, and when to seek medical attention is needed for patients receiving oxygen therapy at home

Weaning from Oxygen Therapy

• This involves the gradual reduction of oxygen flow rate or FiO2
• Monitoring the patient's SpO2 and respiratory status
• Assessing the patient's ability to maintain adequate oxygenation without supplemental oxygen
• Discontinuation of oxygen therapy occurs when the patient can maintain SpO2 above the target range

Oxygen therapy delivers oxygen to individuals with breathing-related conditions, increasing blood oxygen saturation, typically maintained above 90%. It's administered in hospitals, clinics, and homes via nasal cannulas, masks, and ventilators. Monitoring patient response is crucial for adjusting flow rate and delivery method.