Cochin Cardiac Club

Health Blog by Dr.Uday Nair


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 therapy benefits the patient by increasing the supply of oxygen to the lungs and thereby increasing the availability of oxygen to the body tissues.It helps in preventing heart failure in people with severe lung diseases, such as COPD. Some studies have shown an increase in survival rates in patients who use oxygen more than 15 hours a day. Moreover supplemental oxygen improves sleep, mood, mental alertness and stamina and allows individuals to carry out normal, everyday functions.

An injured or ill person can benefit greatly from receiving air with a higher oxygen concentration.The air a person normally breathes contains approximately 21 percent oxygen. The concentration of oxygen delivered to a victim through rescue breathing is 16 percent.Without adequate oxygen, hypoxia, a condition in which insufficient oxygen reaches the cells, will occur.

Signs and symptoms of hypoxia include

    Increased breathing and heart rate.Changes in level of consciousness.
    Cyanosis (bluish lips and nailbeds).
    Chest pain
Always provide emergency oxygen to a victim having difficulty breathing if it is available.

Emergency oxygen should be considered if

An adult is breathing fewer than 12 breaths per minute or more than 20 breaths per minute.
A child is breathing fewer than 15 breaths per minute or more than 30 breaths per minute.
An infant is breathing fewer than 25 breaths per minute or more than 50 breaths per minute.

Indications for Oxygen Therapy

Acute Diseases and Conditions

You may receive oxygen therapy if you're in the hospital for a serious condition that prevents you from getting enough oxygen. Once you've recovered from the condition, the oxygen will likely be stopped.

Some diseases and conditions that may require short-term oxygen therapy are:
  • Severe pneumonia. Pneumonia is an infection in one or both of the lungs. If severe, the infection causes your lungs' air sacs to become very inflamed. This prevents the air sacs from moving enough oxygen into your blood.
  • Severe asthma attack. Asthma is a lung disease that inflames and narrows the airways. Most people who have asthma, including many children, can safely manage their symptoms. But if you have a severe asthma attack, you may need hospital care that includes oxygen therapy.
  • Respiratory distress syndrome (RDS) or bronchopulmonary dysplasia (BPD) in premature babies. Premature babies may develop one or both of these serious lung conditions. As part of their treatment, they may receive extra oxygen through a nasal continuous positive airway pressure (NCPAP) machine or a ventilator, or through a tube in the nose.

Chronic Diseases and Conditions

Long-term home oxygen therapy might be used to treat some diseases and conditions, such as:
  • COPD (chronic obstructive pulmonary disease). This is a progressive disease in which damage to the air sacs prevents them from moving enough oxygen into the bloodstream. "Progressive" means the disease gets worse over time.
  • Late-stage heart failure. This is a condition in which the heart can't pump enough oxygen-rich blood to meet the body's needs.
  • Cystic fibrosis (CF). CF is an inherited disease of the secretory glands, including the glands that make mucus and sweat. People who have CF have thick, sticky mucus that collects in their airways. The mucus makes it easy for bacteria to grow. This leads to repeated, serious lung infections. Over time, these infections can severely damage the lungs.
  • Sleep-related breathing disorders that lead to low levels of oxygen in the blood during sleep, such as sleep apnea.


COPD Treatment

Chronic obstructive pulmonary disease is actually a group of lung diseases, such as emphysema and chronic bronchitis. Because of damaged airways, there isn't a proper oxygen/carbon dioxide exchange in breathing. This makes your heart work harder to pump needed oxygen to your organs. Oxygen therapy eases the strain of breathing on the patient. COPD as a leading cause of death worldwide.The positive effects of oxygen therapy with COPD as improves heart function, the ability to exercise, relief from depression, improved mental clarity and overall better quality, and sometimes length, of life.

Interstitial Lung Disease Treatment

Oxygen is used in treatment of interstitial lung disease, which refers to a range of maladies that result in scarring of the lungs. It can be due to trauma, toxic intake, drugs or other unknown causes. It is reported that oxygen therapy can't reverse the progression, it aids the sufferer in breathing. It can make sleep easier for the patient and reduce blood pressure on the right side of the heart, protecting you from pulmonary hypertension, a weakening and sometimes fatal failing of the right ventricle heart muscle.

Accidental Poisoning Treatment

Oxygen therapy is part of the treatment for alcohol and carbon monoxide poisoning. While alcohol poisoning often happens during binge drinking, it can also occur accidentally when household products with alcohol content are ingested. Carbon monoxide, or CO, poisoning due to poor venting, appliances or faulty auto exhaust systems is the most common cause of death from poisoning Oxygen therapy is used to replace the carbon monoxide in the blood in the case of CO poisoning. With alcohol poisoning, oxygen therapy is used along with intravenous hydration, airway protection and careful monitoring.

Gangrene Treatment

Hyperbaric oxygen therapy is part of the treatment for gangrene, where interrupted blood flow has caused the death of living tissue, especially in the extremities like fingers and toes in frostbite. A chamber with 2.5 times atmospheric pressure of pure oxygen is used to help your blood carry more oxygen to your affected tissue and inhibit bacteria growth.

Pneumonitis Treatment

Pneumonitis refers to an inflammation of lung tissue including pneumonia. It could also refer to illness as a result of exposure to asbestos, chemotherapy, radiation therapy to the chest, over-exposure to poultry and certain types of mold. Besides antibiotics to fight infection and corticosteroids to reduce inflammation,oxygen therapy is prescribed for use as needed, during exercise or sleep, depending on the patient.

Oxygen Therapy at Home

One great benefit of oxygen therapy is it can be delivered at home as well as in the hospital.Home oxygen therapy might be prescribed for a number of illnesses in which your blood doesn't get enough oxygen, called hypoxemia. While atmospheric air contains only 21 percent oxygen, oxygen therapy delivers pure oxygen. This can reduce shortness of breath and strain on your heart. It also improves quality of life by making independent activities of daily living possible with portable oxygen tanks.

Potential Complications and Hazards

  • CO2 Narcosis - This occurs in patients who have chronic respiratory obstruction or respiratory insufficiency which results in them developing hypercapnia (i.e. raised PaCO2). In these patients the respiratory centre relies on hypoxaemia to maintain adequate ventilation. If these patients are given oxygen this can reduce their respiratory drive, causing respiratory depression and a further rise in PaCO2. Resulting in increased CO2 levels in the blood and CO2 narcosis. Supplemental oxygen improves oxygenation but does not change ventilation. Monitoring of SpO2 or SaO2 informs of oxygenation only. Therefore, beware of the use of high FiO2 in the presence of reduced minute ventilation.
  • Pulmonary Atelectasis (alveolar collapse)
  • Pulmonary oxygen toxicity - High concentrations of oxygen (>60%) may damage the alveolar membrane when inhaled for more than 48 hours resulting in pathological lung changes.
  • Retrolental fibroplasia (premature/newborns) & ocular effects for older patients
  • Substernal pain
  • Supports combustion- be alert to safety/fire precautions

Oxygen safety

  • Oxygen is not a flammable gas but it does support combustion (rapid burning). Due to this the following rules should be followed:
  • Do not smoke in the vicinity of oxygen equipment.
  • Do not use aerosol sprays in the same room as the oxygen equipment.
  • Oxygen is heavier than air and will pool in fabric making the material more flammable. Therefore, never leave the nasal cannula or mask under or on bed coverings or cushions whilst the oxygen is being supplied.
  • Oxygen cylinders should be secured safely to avoid injury.
  • Do not store oxygen cylinders in hot places.
  • Keep the oxygen equipment out of reach of children
  • Do not use any petroleum products or petroleum byproducts e.g. petroleum jelly/Vaseline whilst using oxygen
Please Note-

Oxygen is a basic human need. Without it, we would not survive. The air that we breathe contains approximately 21% oxygen. For most people with healthy lungs, this is sufficient, but for some people with certain health conditions whose lung function is impaired, the amount of oxygen that is obtained through normal breathing is not enough. Therefore, they require supplemental amounts to maintain normal body function.

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