Overview
- Supplemental oxygen is a drug and should be used rationally for specific indications, at the lowest concentration and for the shortest time possible.
Indications for Supplemental Oxygen
- Hypoxia
- Cardiac or respiratory arrest
- Acute respiratory distress
- Specific conditions - pulmonary hypertension, myocardial infarction, pneumothorax
- Supplemental oxygen is not indicated for patients with breathlessness.
Complications of Supplemental Oxygen
- Hypoventilation - due to suppression of the hypoxic respiratory drive; particularly in patients with COPD
- Absorption atelectasis (due to washout of nitrogen, which noramlly splints the airways open)
- Oxygen toxicity - damage to upper or lower airways due to oxygen radical formation
Monitoring
- Oxygen saturations should be used to guide supplemental oxygen administration. The target oxygen saturation for most patients should be 92-96%, while in patients with chronic respiratory failure this target should be 88-92%.
- Arterial blood gases are also used to guide oxygen therapy in certain patients.
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