Abstract

Oxygen is a colorless, odorless, tasteless gas that is essential for the body to
function properly and to survive. Oxygen therapy is a key treatment in
respiratory care.
The body is constantly taking in oxygen and releasing carbon dioxide.
If this process is inadequate, oxygen levels in the blood decrease, and the
patient may need supplemental oxygen.
The purpose is to increase oxygen saturation in tissues where the saturation
levels are too low due to illness or injury. Oxygen, a gas found in the air we
breathe, is necessary for human life. Some people with breathing
disorders can’t get enough oxygen naturally. They may need
supplemental oxygen, or oxygen therapy. People who receive oxygen
therapy often see improved energy levels and sleep, and better quality of
life.
Introduction

While the history of oxygen therapy dates back to 1885, when Dr. George

Holzapple first used oxygen to treat pneumonia, the history of oxygen—or the
discovery of it, to be more precise—is a bit more complex. The discovery
of oxygen dates back to 1772, when Swedish chemist Carl Wilhelm Scheele
discovered its existence.
Oxygen is widely used in emergency medicine, both in hospital and by emergency
medical services or those giving advanced first aid.

In the pre-hospital environment, high-flow oxygen is indicated for use

in resuscitation, major trauma, anaphylaxis, major bleeding, shock,
active convulsions, and hypothermia. Oxygen, a gas found in the air we breathe, is
necessary for human life. Some people with breathing disorders can’t get enough
oxygen naturally. They may need supplemental oxygen, or oxygen therapy. People
who receive oxygen therapy often see improved energy levels and sleep, and better
quality of life. Your doctor will write you a prescription to begin oxygen therapy.
They’ll tell you how to use it and how often you should use it. This will include the
flow rate, or how much oxygen you’ll need per minute. It is essential that you
follow all of your doctor’s specific instructions. If you don’t think the oxygen
therapy is working for you, see them before making any changes.

Some people only need oxygen during certain activities, like exercising or
sleeping. Other people need oxygen constantly. Most types of oxygen therapy
come with portable oxygen tanks so you can leave home with them if necessary.
Do not use drugs or alcohol while taking oxygen therapy, as they can slow your
breathing. When discussing oxygen therapy with your doctor, make them aware of
any other prescription medications you may be taking.

Oxygen therapy is a treatment that provides you with supplemental, or extra,

oxygen. Although oxygen therapy may be common in the hospital, it can also be
used at home. There are several devices used to deliver oxygen at home. Your
healthcare provider will help you choose the equipment that works best for you.
Oxygen is usually delivered through nasal prongs (an oxygen cannula) or a face
mask. Oxygen equipment can attach to other medical equipment such as CPAP
machines and ventilators.
Oxygen therapy can help you feel better and stay active. Learning all you can
about oxygen therapy can help you feel more comfortable and confident.
Theory

Oxygen is a gas that is vital to human life. It is one of the gases that is found in the
air we breathe. If you have a chronic lung disease, you may need additional
(supplemental) oxygen for your organs to function normally.
Here are some conditions that may require supplemental oxygen, either
temporarily or long-term:

 chronic obstructive pulmonary disease (COPD)

 pneumonia
 asthma
 bronchopulmonary dysplasia, underdeveloped lungs in newborns
 heart failure
 cystic fibrosis
 sleep apnea
 lung disease
 trauma to the respiratory system

Oxygen therapy is a treatment that provides you with supplemental, or extra,

oxygen. Although oxygen therapy may be common in the hospital, it can also be
used at home. There are several devices used to deliver oxygen at home. Your
healthcare provider will help you choose the equipment that works best for you.
Oxygen is usually delivered through nasal prongs (an oxygen cannula) or a face
mask. Oxygen equipment can attach to other medical equipment such as CPAP
machines and ventilators.
Oxygen therapy can help you feel better and stay active. Learning all you can
about oxygen therapy can help you feel more comfortable and confident.
When you aren’t getting enough oxygen, you’ll experience a host of
symptoms, including:

 rapid breathing
 shortness of breath
 fast heart rate
 coughing or wheezing
 sweating
 confusion
 changes in the color of your skin

If you experience any of these symptoms, seek immediate medical attention.

There are a number of different types of oxygen therapies that can be used.
These include:

 oxygen gas
 liquid oxygen
 oxygen concentrators
 hyperbaric oxygen therapy

 Oxygen gas

Oxygen gas can be stored in a portable tank. These are called compressed
gas systems. A larger stationary concentrator is used within the home, and a
smaller oxygen tank can be taken to use outside the home. The smaller tanks
might be used along with oxygen-conserving devices so that the oxygen
supply lasts longer. The oxygen is delivered in pulses, not continuously.
  Liquid oxygen

Liquid oxygen also can be stored in a portable tank. Liquid oxygen is more
highly concentrated, so more oxygen can fit in a smaller tank. This is helpful
for people who are very active, but it will evaporate if it isn’t used in a timely
manner. These tanks are refillable.

Both liquid oxygen and oxygen gas are available for home delivery in many
locations.

 Oxygen concentrators

Oxygen concentrators are less portable than the other options. An oxygen
concentrator is a device that takes oxygen from the room, concentrates it for
therapeutic use, and removes other naturally occurring gases. The benefits of
concentrators are that they are less expensive and don’t require filling like
tanks. Portable versions are available. However, most models are too large to
be truly portable.

Oxygen is distributed from the tank through a tube. It enters the lungs through
nasal tubes, a face mask, or a tube inserted directly into the person’s
windpipe.
  Hyperbaric oxygen therapy

Hyperbaric oxygen therapy is unlike the other methods of oxygen therapy.

People will breathe in pure oxygen in a pressurized room or chamber. In the
hyperbaric chambers, the air pressure is increased to three or four times the
normal air pressure levels. This increases the amount of oxygen delivered to
the body’s tissue. This type of oxygen delivery is often used to treat wounds,
serious infections, or bubbles of air in your blood vessels. Hyperbaric therapy
should be carried out carefully so that blood oxygen levels don’t become too
high.

Oxygen therapy can be extremely beneficial for those who frequently

experience low oxygen levels, regardless of the reason. If needed, regularly
utilizing oxygen therapy can allow people to be more active and mobile by
decreasing shortness of breath. It also can significantly improve quality of life,
and in many cases extend life expectancy.

Oxygen therapy can also reduce symptoms such as:

 headaches
 irritability
 fatigue
 swollen ankles

Oxygen therapy can help the growth and development of children who have
chronic lung conditions. It can also lessen symptoms such as headaches
caused by low oxygen levels, and behavioral changes or problems.
Oxygen Delivery Systems
1. Nasal Cannula
2. Simple Mask
3. Partial Re-Breather Mask
4. Non-Re Breather Mask (NRBM)
5. Venturi Mask
6. Oxygen Hood
7. Oxygen Tent
8. AMBU Bag
9. Tracheostomy Collar,
10. T-piece
Oxygen delivery devices are used to deliver oxygen to patients at different
concentrations
Low flow oxygen devices work by supplying oxygen at flow rates less than the
atient’s inspiratory flow, usually 1 to 10 liters per minute  The remaining
spired flow comes from the atmospheric air, diluting the delivered O2.
High flow oxygen devices supply flow rates high enough to accommodate two
three (2-3) times the patient’s inspiratory volume at 1 to 40 liters per minute.
 low Flow
(variable performance)
• Low flow nasal cannula
• Reservoir Systems
- Face mask
- Nonrebreather mask
- Partial rebreather mask
• Face tent
• Nasal catheter
• Trans-tracheal catheter
Variable oxygen concentration depending
on the MV or PIFR
 High Flow
(fixed performance)
• High flow nasal cannula
• Mechanical ventilators
• Hyperbaric oxygen chambers
• Venturi mask
• Tracheostomy collar and T-piece
• Ambu bag
Fixed concentration of Oxygen
irrespective of the minute volume or PIFR
of the patient.
Conclusion

Oxygen therapy is known to improve mortality in patients with severe hypoxaemia and COPD. Patients
currently receiving this treatment are often older and have more co-morbidities than the patients who
were enrolled in the original long term oxygen studies. Further studies and the development of national
and perhaps international registries should allow clarification of the impact of oxygen therapy on COPD
patients receiving oxygen therapy currently. Benefits from oxygen in patients with milder degrees of
hypoxaemia who may desaturate on exertion or nocturnally are unclear and require further study. Such
future prospective studies should include a placebo arm in order to distinguish benefit due to oxygen
from placebo effect.
References

1. Severinghaus JW, Astrup PB. History of blood gas analysis. V. Oxygen measurement. J Clin
Monit 1986.

2. Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic
bronchitis and emphysema. Report of the Medical Research Council Working
Party. Lancet 1981.

3. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a

clinical trial. Nocturnal Oxygen Therapy Trial Group. Ann Intern Med 1980.

4. Crockett AJ, Cranston JM, Moss JR, et al. Survival on long-term oxygen therapy in chronic airflow
limitation: from evidence to outcomes in the routine clinical setting. Intern Med J 2001.

5. Chaouat A, Weitzenblum E, Kessler R, et al. Outcome of COPD patients with mild daytime

hypoxaemia with or without sleep-related oxygen desaturation. Eur Respir J 2001.
6.  Fletcher EC, Luckett RA, Goodnight-White S, et al. A double-blind trial of nocturnal
supplemental oxygen for sleep desaturation in patients with chronic obstructive pulmonary
disease and a daytime PaO2 above 60 mm Hg. Am Rev Respir Dis 1992.