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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