which patients need oxygen therapy？
All patients with hypoxemia need oxygen therapy. Hypoxemia needs to be considered when the patients have the following manifestations, such as irritability, anxiety, disorientation, confusion, listlessness, headache, etc. Cyanosis, erythrocytosis, elevated blood pressure, tachycardia, hypotension, atrial fibrillation, Chen-Shi respiration, apnea, cardiac arrest, coma, etc. may indicate that the patient may have moderate to severe hypoxemia. In the above cases, oxygen therapy should be given as soon as possible, and the patient’s peripheral blood oxygen saturation and arterial blood gas analysis should be checked in time.
Which oxygen therapy method to choose？
1. Nasal catheter
Simple, convenient and well tolerated by patients. The inhaled oxygen concentration of the nasal cannula can be roughly calculated according to the formula FiO2=21+4×inhaled oxygen flow rate (L/min). It is recommended that the inhaled oxygen concentration should not exceed 50%.
2. Simple mask
Compared with the nasal cannula, the mask can form an additional oxygen storage space of 100-200ml, so the inhaled oxygen concentration can be increased to more than 45%, usually up to 50-100%. However, oxygen inhalation by mask also has its own problems, such as being affected when eating or drinking, and it is easy to cause aspiration.
3. High-flow oxygen inhalation
This type of oxygen supply device can provide a larger inhalation flow rate and can maintain a relatively stable inhaled oxygen concentration. Commonly used are venturi cover, oxygen storage atomizer, etc.
4. Hyperbaric oxygen therapy
Hyperbaric oxygen therapy is mainly used for decompression sickness, acute wounds, infections and long-lasting ulcers. By increasing oxygen delivery, reducing the size of bubbles in small blood vessels, increasing tissue oxygenation, and improving wound healing. However, hyperbaric oxygen therapy has many contraindications, such as obstructive pulmonary disease, upper respiratory tract infection or trauma, and claustrophobia. For patients with untreated pneumothorax, hyperbaric oxygen therapy is absolutely contraindicated. Related complications include reversible myopia, symptomatic ear pressure, lung pressure, lung oxygen poisoning and convulsions.
5. Long-term oxygen therapy
Patients with long-term chronic hypoxemia need to be treated with oxygen for a longer period of time every day and adhere to long-term treatment. At present, COPD patients are the most widely used, which is beneficial to improve their quality of life and prognosis.
What are the precautions for oxygen therapy
1. Airway humidification
Poor humidification can cause respiratory tract mucosal damage, dry sputum, patient tolerance, airway obstruction, and even suffocation. Especially for patients with poor sputum excretion and unconsciousness, special attention should be paid to humidification.
2. Oxygen concentration
The oxygen concentration is too low to achieve the therapeutic effect, and too high will inhibit the respiratory center and aggravate hypercapnia.
3. Oxygen poisoning
In addition to the concentration of inhaled oxygen, the duration of oxygen therapy is also one of the risk factors for oxygen poisoning. For 100% pure oxygen therapy, the treatment time should not exceed 24 hours. Special reminder: For severely ill or special patients, oxygen therapy is very professional, and professional physicians must give oxygen guidance. For more professional oxygen therapy knowledge, please call: 0312-5959797