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Oxygen Therapy: Indications, Benefits, Methods, and Applications

Navneet Dahiya

Introduction

Oxygen therapy is a medical treatment that delivers supplemental oxygen to patients with breathing disorders or insufficient oxygen levels in their blood. This therapy is vital for individuals with chronic obstructive pulmonary disease (COPD), pneumonia, asthma, heart failure, and other conditions that impair lung function. In this comprehensive guide, we will explore the indications, benefits, methods, and applications of oxygen therapy, providing an in-depth understanding of this life-saving treatment.

The goal of oxygen therapy is to maintain adequate levels of oxygen to manage suspected or confirmed hypoxemia and prevent hypoxia. Selection of the type of oxygen therapy is based on the patient’s need, the severity of hypoxemia, and the disease process. Signs and symptoms of mild hypoxia include restlessness, anxiety, disorientation, confusion, and fatigue.

Indications

Benefits of Oxygen Therapy

1. Improved Oxygen Levels

Oxygen therapy helps increase the amount of oxygen in the blood, ensuring that vital organs receive the oxygen they need to function properly. This can prevent complications associated with low oxygen levels, such as organ damage and respiratory failure.

2. Enhanced Quality of Life

By alleviating symptoms like shortness of breath, fatigue, and confusion, oxygen therapy can significantly improve the quality of life for patients. It enables them to perform daily activities with greater ease and participate more actively in social and physical activities.

3. Better Sleep Quality

For patients with sleep apnea or other breathing disorders that affect sleep, oxygen therapy can help maintain stable oxygen levels throughout the night, leading to better sleep quality and overall health.

4. Reduced Heart Strain

Supplemental oxygen reduces the workload on the heart by ensuring adequate oxygen delivery to tissues and organs. This can be particularly beneficial for patients with heart conditions, as it helps prevent heart strain and associated complications.

Methods of giving Oxygen Therapy

1. Nasal Cannula

A nasal cannula is a lightweight, flexible tube with two prongs that fit into the nostrils. It delivers low-flow oxygen and is commonly used for patients who require continuous oxygen therapy but can still breathe on their own.

• Oxygen Delivery: Delivers 1-6 liters of oxygen per minute.
• Oxygen Concentration: Provides 24 – 44% oxygen concentration.

Types of Nasal Cannula :-

A nasal cannula can be high-flow or low-flow. A flow rate is a measurement of how much oxygen you’re getting through the cannula. It’s usually measured in liters. There’s a device on your oxygen supply that controls the flow of oxygen.

High-flow nasal cannulas deliver warm oxygen. It can deliver up to about 60 liters of oxygen per minute. It delivers warm oxygen because oxygen at this flow rate could dry up your nasal passages quickly and lead to nosebleeds.
Low-flow nasal cannulas don’t deliver warm oxygen. Because of this, they tend to dry out your nasal passages quicker. The flow rate for a low-flow cannula is up to about 6 liters of oxygen per minute.

NOTE :- Low flow rate nasal cannulas are mostly used for COPD (Chronic Obstructive Pulmonary Disease) patients.

2. Nasal Catheter

A nasal catheter is thin and soft, flexible tube inserted directly into the nasal passage and is designed for patients requiring low to moderate levels of oxygen over a prolonged period. They are commonly used in home care, long-term care facilities, and hospitals.

NOTE :- Change position of nasal catheter from one nostril to another after every 8 hours.

3. Oxygen Masks

Oxygen masks cover the nose and mouth, delivering a higher concentration of oxygen compared to nasal cannula and nasal catheter.

The body of the mask stores oxygen between the patient’s breaths. Side port openings located on either side of the mask allow room air to mix with delivered oxygen and allow exhaled air to escape

NOTE :- Using a simple mask with a flow rate less than 5 L/min causes the mask volume to act as dead space and causes carbon dioxide rebreathing.

4. Venturi mask

Venturi mask is a medical device with entrainment ports of various sizes at its base. The entrainment ports adjust to deliver various oxygen concentrations. This mask is useful because it delivers a more precise concentration of oxygen to the patient

5. Non-Rebreather Masks

Non-Rebreather Masks have a reservoir bag that fills with pure oxygen, allowing patients to breathe in a high concentration of oxygen without rebreathing exhaled air due to the presence of one-way valves, making it essential in emergency and acute care settings.

Capacity of reservoir bag : Typically holds about 600-1000 mL of oxygen

One way valves :

Functionality : Oxygen flows from the source through the tubing into the reservoir bag, filling it. When the patient inhales, oxygen from the reservoir bag flows through the inhalation valve into the mask, ensuring a high concentration of oxygen is delivered. When the patient exhales, the exhaled air is directed out of the mask through the exhalation valves, preventing it from mixing with the oxygen in the reservoir bag.

6. Partial Rebreather Mask:

Description: Similar to the non-rebreather mask but with no one-way valve between the mask and reservoir bag.

Applications of Oxygen Therapy

1. Chronic Obstructive Pulmonary Disease (COPD)

Oxygen therapy is a cornerstone treatment for COPD patients, helping to reduce symptoms, improve exercise tolerance, and enhance the quality of life. Long-term oxygen therapy has been shown to increase survival rates in COPD patients with chronic respiratory failure.

2. Pneumonia

Patients with severe pneumonia may require supplemental oxygen to maintain adequate oxygen levels in the blood and support recovery. Oxygen therapy can help reduce the risk of complications and speed up the healing process.

3. Asthma

During severe asthma attacks, oxygen therapy can be used to ensure that patients receive enough oxygen while their airways are constricted. This is often administered in emergency settings.

4. Heart Failure

For patients with heart failure, oxygen therapy can help alleviate symptoms of breathlessness and fatigue, improving overall heart function and reducing the risk of complications.

5. Sleep Apnea

Oxygen therapy is sometimes used in conjunction with continuous positive airway pressure (CPAP) machines for patients with sleep apnea. It helps maintain stable oxygen levels during sleep, improving sleep quality and reducing daytime fatigue.

6. Acute Respiratory Distress Syndrome (ARDS)

Patients with ARDS often require high levels of supplemental oxygen to support lung function and maintain adequate oxygenation. Oxygen therapy is a critical component of the treatment plan in intensive care units.

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