In recent years, more and more people have paid more attention to the role of oxygen therapy in health care. Oxygen therapy is not only an important medical method in medicine, but also a fashionable home health regimen.
What is Oxygen Therapy?
Oxygen therapy is a medical measure that relieves or corrects the body’s hypoxic state by increasing the oxygen concentration in the inhaled air.
Why do you need oxygen?
It is mainly used to relieve conditions that occur during hypoxia, such as dizziness, palpitation, chest tightness, suffocation, etc. It is also used to treat major diseases. At the same time, oxygen can also improve the body’s resistance and promote the metabolism.
The Effect of Oxygen
Inhaling oxygen can help improve blood oxygen and help the patient’s respiratory system return to normal as soon as possible. Normally persist in oxygen therapy,can effectively alleviate the condition.In addition, oxygen can improve the patient’s neurological function, the body’s immune function and body metabolism.
Contraindications and indications for oxygen
There are no absolute contraindications to oxygen inhalation
Oxygen is suitable for acute or chronic hypoxemia,Such as: burns, lung infection, COPD, congestive heart failure, pulmonary embolism, shock with acute lung injury, carbon monoxide or cyanide poisoning, gas embolism and other conditions.
Principles of oxygen
Prescription principles:Oxygen should be used as a special drug in oxygen therapy, and a prescription or doctor’s order for oxygen therapy should be issued.
De-escalation principle:For patients with severe hypoxemia of unknown cause, the principle of de-escalation should be implemented, and oxygen therapy from high concentration to low concentration should be selected according to the condition.
Goal-oriented principle:Choose reasonable oxygen therapy targets according to different diseases. For patients at risk of carbon dioxide retention, the recommended oxygen saturation target is 88%-93%, and for patients without risk of carbon dioxide retention, the recommended oxygen saturation target is 94-98%
Commonly used oxygen breathing tools
- Oxygen tube
The most commonly used oxygen in clinical practice,The volume fraction of oxygen inhaled by the oxygen tube is related to the oxygen flow rate, but the oxygen tube cannot be fully humidified, and the patient cannot tolerate a flow rate exceeding 5L/min.
- Mask
- Ordinary mask:It can provide an inspired oxygen volume fraction of 40-60%, and the oxygen flow rate should not be less than 5L/min. It is suitable for patients with hypoxemia and no risk of hypercapnia.
- Partial rebreathing and non-rebreathing oxygen storage masks:For partially rebreathing masks with good sealing, when the oxygen flow is 6-10L/min, the volume fraction of inspired oxygen can reach 35-60%. The oxygen flow rate of non-rebreathing masks must be at least 6L/min. They are not suitable for those with the risk of CO2 retention. of patients with chronic obstructive pulmonary disease.
- Venturi mask:It is an adjustable high-flow precision oxygen supply device that can provide oxygen concentrations of 24%, 28%, 31%, 35%, 40% and 60%. It is suitable for hypoxic patients with hypercapnia.
- Transnasal high flow oxygen therapy device:Nasal high-flow oxygen therapy devices include nasal cannula oxygen systems and air oxygen mixers. It is mainly used in acute respiratory failure, sequential oxygen therapy after extubation, bronchoscopy and other invasive operations. In clinical application, the most obvious effect is in patients with acute hypoxic respiratory failure.
Nasal oxygen tube operation method
Instructions for use: Insert the nasal plug on the oxygen inhalation tube into the nostril, loop the tube from behind the patient’s ear to the front of the neck and put it on the ear
Note: Oxygen is supplied through the oxygen inhalation tube at a maximum speed of 6L/min. Reducing the oxygen flow rate can reduce the occurrence of nasal dryness and discomfort. The length of the oxygen inhalation tube should not be too long to prevent the risk of strangulation and suffocation.
Advantages and Disadvantages of Nasal Oxygen Cannula
The main advantages of nasal oxygen tube oxygen inhalation are that it is simple and convenient, and does not affect expectoration and eating. The disadvantage is that the oxygen concentration is not constant and is easily affected by the patient’s breathing.
How to oxygen with ordinary mask
Ordinary masks do not have air storage bags. There are exhaust holes on both sides of the mask. The surrounding air can circulate when inhaling and the gas can be exhaled when exhaling.
Note: Disconnected pipelines or low oxygen flow rates will cause the patient to receive insufficient oxygen and re-breathe exhaled carbon dioxide. Therefore, attention should be paid to real-time monitoring and timely resolution of any problems that arise.
Advantages of oxygen with ordinary masks
Non-irritating, for mouth-breathing patients
Can provide a more constant inspired oxygen concentration
Changes in breathing pattern do not alter inspired oxygen concentration
Can humidify oxygen, causing little irritation to nasal mucosa
High-flow gas can promote the elimination of exhaled carbon dioxide in the mask, and there is basically no repeated inhalation of carbon dioxide.
Venturi mask oxygen method
The Venturi mask uses the jet mixing principle to mix ambient air with oxygen. By adjusting the size of the oxygen or air inlet hole, a mixed gas of the required Fio2 is produced. The bottom of the Venturi mask has entrainments of different colors, representing different apertures.
NOTE: Venturi masks are color-coded by manufacturer, so special care is required to properly set the oxygen flow rate as specified.
High flow nasal cannula method
Provide oxygen at a flow rate exceeding 40L/min, overcoming the insufficient oxygen flow caused by ordinary nasal cannulas and masks due to flow rate limitations. The oxygen is heated and humidified to prevent patient discomfort and end-of-year injuries.High-flow nasal cannula produces moderate positive end-expiratory pressure. It relieves atelectasis and increases functional residual capacity, improving respiratory efficiency and reducing the need for endotracheal intubation and mechanical ventilation.
Operation steps: firstly, connect the oxygen tube to the hospital oxygen pipeline, connect the air tube to the hospital air pipeline,set the required oxygen concentration on the air-oxygen mixer, and adjust the flow rate on the flow meter to convert the high-flow nose The catheter is connected to the breathing circuit to ensure adequate airflow through the nasal obstruction. Allow the gas to heat and humidify before cannulating the patient, placing the nasal plug in the nostril and securing the cannula (the tip should not completely seal the nostril)
Note: Before using a high-flow nasal cannula on a patient, it should be set up according to the manufacturer’s instructions or under the guidance of a professional
Why use humidification when inhaling oxygen?
Medical oxygen is pure oxygen. The gas is dry and has no moisture. Dry oxygen will irritate the patient’s upper respiratory tract mucosa, easily cause patient discomfort, and even cause mucosal damage. Therefore, in order to avoid this happening, a humidification bottle needs to be used when giving oxygen.
What water should be added to the humidification bottle?
The humidification liquid should be pure water or water for injection, and can be filled with cold boiled water or distilled water
Which patients require long-term oxygen therapy?
At present, the people who take long-term oxygen mainly include patients with chronic hypoxia caused by cardiopulmonary insufficiency, such as patients with mid-term and terminal COPD, end-stage interstitial pulmonary fibrosis and chronic left ventricular insufficiency. The elderly are often the main victims of these diseases.
Oxygen flow classification
Low flow oxygen inhalation oxygen concentration 25-29%,1-2L/min,suitable for patients with hypoxia accompanied by carbon dioxide retention, such as chronic obstructive pulmonary disease, type II respiratory failure, cor pulmonale, pulmonary edema, postoperative patients, patients with shock, coma or brain disease, etc.
Medium-flow oxygen inhalation concentration 40-60%, 3-4L/min, suitable for patients with hypoxia and no carbon dioxide retention
High-flow oxygen inhalation has an inhaled oxygen concentration of more than 60% and more than 5L/min. It is suitable for patients with severe hypoxia but not carbon dioxide retention. Such as acute respiratory and circulatory arrest, congenital heart disease with right-to-left shunt, carbon monoxide poisoning, etc.
Why do you need oxygen after surgery?
Anesthesia and pain can easily cause breathing restrictions in patients and lead to hypoxia, so the patient needs to be given oxygen to increase the patient’s blood oxygen partial pressure and saturation, promote the patient’s wound healing, and prevent damage to the brain and myocardial cells. Relieve patient’s postoperative pain
Why choose low-concentration oxygen inhalation during oxygen therapy for chronic lung patients?
Because chronic obstructive pulmonary disease is a persistent pulmonary ventilation disorder caused by airflow limitation, patients have varying degrees of hypoxemia and carbon dioxide retention. According to the oxygen supply principle “patient carbon dioxide When the partial pressure of carbon dioxide rises, low-concentration oxygen inhalation should be given; when the partial pressure of carbon dioxide is normal or reduced, high-concentration oxygen inhalation can be given.”
Why patients with brain trauma choose oxygen therapy？
Oxygen therapy can help improve the therapeutic effect of patients with brain trauma, promote the recovery of neurological functions, improve nerve cell edema and inflammatory reactions, reduce damage to nerve cells by endogenous toxic substances such as oxygen free radicals, and accelerate the recovery of damaged brain tissue.
Why is oxygen poisoning？
“Poisoning” caused by inhaling excess oxygen beyond the body’s normal needs
Symptoms of oxygen poisoning
Oxygen poisoning is generally manifested in its impact on the lungs, with symptoms such as pulmonary edema, cough, and chest pain; secondly, it may also manifest as eye discomfort, such as visual impairment or eye pain. In severe cases, it will affect the nervous system and lead to neurological disorders. In addition, inhaling excessive oxygen can also inhibit your breathing, cause respiratory arrest, and be life-threatening.
Treatment of oxygen toxicity
Prevention is better than cure. Avoid long-term, high-concentration oxygen therapy. Once it occurs, first lower the oxygen concentration. Special attention is required: the most important thing is to correctly select and control the oxygen concentration.
Will frequent oxygen inhalation cause dependence?
No, oxygen is necessary for the human body to function at all times. The purpose of inhaling oxygen is to improve the body’s oxygen supply. If the hypoxic condition is improved, you can stop inhaling oxygen and there will be no dependence.
Why does oxygen inhalation cause atelectasis?
When a patient inhales high-concentration oxygen, a large amount of nitrogen in the alveoli is replaced. Once there is bronchial obstruction, the oxygen in the alveoli to which it belongs will be rapidly absorbed by the pulmonary circulation blood, causing inhalation atelectasis. It is manifested by irritability, breathing and heartbeat. Accelerate, blood pressure rises, and then you may find difficulty breathing and coma.
Preventive measures: Take deep breaths to prevent secretions from blocking the airway
Will retrolental fibrous tissue proliferate after oxygen inhalation?
This side effect is only seen in newborns, and is more common in premature infants. It is mainly due to retinal vasoconstriction, retinal fibrosis, and ultimately leads to irreversible blindness.
Preventive measures: When newborns use oxygen, the oxygen concentration and oxygen inhalation time must be controlled
What is respiratory depression?
It is common in patients with type II respiratory failure. Since the partial pressure of carbon dioxide has been at a high level for a long time, the respiratory center has lost its sensitivity to carbon dioxide. This is a condition where the regulation of breathing is mainly maintained by the stimulation of peripheral chemoreceptors by hypoxia. If this occurs When patients are given high-concentration oxygen to inhale, the stimulating effect of hypoxia on breathing will be relieved, which will aggravate the depression of the respiratory center and even cause respiratory arrest.
Preventive measures: Give low-concentration, low-flow continuous oxygen (oxygen flow 1-2L/min) to patients with II respiratory failure to maintain normal breathing.
Why do critically ill patients need to take a break during high-flow oxygen inhalation?
For those with critical condition and acute hypoxia, high-flow oxygen can be given at 4-6L/min. This oxygen concentration can reach 37-45%, but the time should not exceed 15-30 minutes. If necessary, use it again every 15-30 minutes.
Because the respiratory center of this kind of patient is less sensitive to the stimulation of carbon dioxide retention in the body, it mainly relies on hypoxic oxygen to stimulate the chemoreceptors of the aortic body and carotid sinus to maintain breathing through reflexes. If the patient is given high-flow oxygen, the hypoxic state When released, the reflex stimulation of breathing by the aortic body and carotid sinus weakens or disappears, which can cause apnea and endanger life.
Post time: Oct-23-2024