Oxygen Therapy

Hasanul Arifin

Departemen Anestesiologi dan Terapi Intensif

FKUSU-RSUP. H. Adam Malik Medan.

Introduction
The function of respiration is to provide an
adequate supply of O2 to the pulmonary
capillaries
and remove CO2 from the alveoli.
2 principal purposes:
- to maintain adequate arterial PaO2, and

- to regulate arterial PaCO2

maintain a stable acidbase state.
Both are necessary to sustain normal tissue
metabolism.

Definition
O2 therapy is the administration of O2
at concentrations greater than that
in ambient air with the intent of
treating or preventing the symptoms
and manifestations of hypoxia.

RESPIRATORY CARE JUNE 2002 VOL 47 NO 6

Indications
Hypoxemia PaO2 in the blood below
normal range. PaO2 (< 60 mmHg or SaO2
of < 90% in subjects breathing room air or
with PaO2 and/or SaO2 below desirable
range for specific clinical situation).
Severe trauma
Acute myocardial infarction
Short-term therapy or surgical intervention
(eg, post-anesthesia recovery, hip surgery)
RESPIRATORY CARE JUNE 2002 VOL 47 NO 6

O2 Delivery Devices Low-Flow

Devices
a. Nasal cannulas
b. Simple face mask
c. Partial Rebreathing mask
d. Nonorebreathing mask

O2 Delivery Devices High-Flow

Devices
a. Venturi masks
b. High-flow nasal cannulas

Management
Acute respiratory failure
ABC (Airway, Breathing, Circulation)
approach
+ high-flow O2 therapy (15 L/min) via a
facemask
fitted with a reservoir bag.
If the patient is not alert and responsive
` maximize airway patency
a jaw thrust manoevre or
oropharyngeal airway

Standard nasal cannula

Delivers FiO2 2440% at flows 15
L/min.
The formula FiO2 = 20% + (4 O2
L flow).

Approximate FIO2 Delivered by Nasal

Cannula
Flow Rate (L/min)
1
2
3
4
5
6 inspired oxygen
FIO2, Fraction of

Approximate
FIO2*
0.24
0.28
0.32
0.36
0.40
0.44

High Concentration Reservoir Mask

Simple Face Mask

The volume 100300 mL.
It delivers FiO2 4060% at 510 L/min.
Is indicated in patients with nasal irritation
or epistaxis.
Useful for patients who are strictly mouth
breathers.
Obtrusive, uncomfortable, confining,
muffles communication, obstructs
coughing, and impedes eating.

Simple Face Mask

Approximate FiO2 Delivered by Simple Face Mask

Flow Rate (L/min)

FiO2*

56
67
78

0.4
0.5
0.6

FiO2, Fraction of inspired oxygen

Nonrebreathing face mask

with reservoir and one-way
valve
Indicated when FiO2 > 40% is required.
Deliver FiO2 > 90% at high flow settings.
O2 flows into the reservoir at 810 L/min,
washing the patient with a high
concentration of O2.
Its major drawback is that the mask must
be tightly sealed on the face, which is
uncomfortable.
There is also a risk of CO2 retention.

Nonrebreathing face mask

with reservoir and one-way
valve

Reservoir cannulas
Improve the efficiency of O2 delivery.
Well oxygenated at lower flows.
O2 8 L/min adequately oxygenate
patients with a high flow requirement

Air Entrainment Masks (Venturi Mask)

Mixes O2 with room air high-flow enriched
O2 of a
settable
concentration.
Accurate and constant FiO2.
FiO2 delivery settings
24, 28, 31, 35, 40%.
Is often employed when
concern CO2 retention.

Air Entrainment Masks (Venturi Mask)

Air Entrainment Masks (Venturi Mask)

Noninvasive ventilation (NIV) refers to the delivery of

mechanical ventilation to the lungs using techniques that
do not require an endotracheal airway.

hank you for listeni

23

THANK YOU FOR

LISTENING