2

Oxygen therapy
Dr.Deopujari

36 A.T.P.

O2
2 A.T.P. L.ACID

BODY OXYGEN STORES ALL SMALL AND IF DEPLETED THEY ARE INSUFFICIENT TO SUSTAIN LIFE FOR MORE THAN FEW

MINUTES

RESP. C.V.S. C.N.S. SEPS.

M. O. F.

Oxygen was first used as a remedy for illness in 1783 in France by Chaussier. In December of 1907, it was used in surgery on a woman who had tremendous internal damage. It was administered directly into the abdomen and marked recovery was noted.

90%
50%

25

60

O.D.CURVE
100 90 80 70 60 SO2 50 40 30 20 10 0 0 10 20 30 40 50 60 70 80 90 100 110 pO2(mm Hg)

O.D.CURVE 120 100 80

SO2

60 40 20 0 0 10 20 30 40 50 60 70 80 90 100 110 PO2

Rt..

PaO2

SATURATION
HB% 12 SAT 100% HB% 12 SAT 50% HB 6 GR SAT 100% HB 13 GR SAT 90%

TISSUES
CaO2 = (SAT x Hb x 1 . 3 4 ) + .0 0 3(PaO2)

PaO2 / FiO2 Ratio or "P/F Ratio Another much friendlier method ( because it doesn't use the alveolar gas equation) used to predict shunt. Just like the name says, PaO2 is divided by FiO2 Normal is 286; lower indicates a shunt.

CLINICAL D. OF HYPOXIA
DISPRAP. BRADY / TACHY . ALTERED SENSORIUM / SEI. SHOCK. G.I.BLEED MULTISYSTEM INV. ANTICIPATE HYPOXIA

ROVING EYES

UNRESPONSIVE PUPIL

P U L S E

0 X.

PERFUSION

DEPNDENT

SAT. NOT CONTENT

SHAPE OF O.D.CURVE

HYPEROXIA NOT DIAG.

POSITION OF CURVE ABNORMAL HEMOGLOBIN

VENTILATORY STATUS ?

SIMPLE OX. MASK

FIO2 VARIABLE 30 TO 60 % FEEDING PROBLEM REBREATHING

NASAL CANNULA
MAX FLOW2LIT/MIN FIO2 DIF. TO CONTROL HUMIDI. NOT NEC. MOUTH / NOSE BREAT.?

NASOPHARYN. CATH.

OROPHARYNX.ANAT. RES. OCCL. OF DIST. OPENING. GASTRIC DISTENSION FIO2 DIFFICULT TO CONT. SECRETIONS CATHER MORE THAN 8 FR.

AIR ENTRAINMENT V. PRE. O2 CONC. <50 % T. FLOW WITH FIO2 NOISE LEVEL ++++ HUMIDIFICATION ?

FI O2 24% 28
31 35

O2/L/MIN 4lit 6
8 10

FLOW 105 68
63 56

40
50

12
12

50
33

YOU
ALMOST

NEVER
NEED

100 %
OXYGEN

HEAD BOX

OXYGEN CONCENTRATOR
LOW PRESSURE OUTLET

PARTIAL REBREATH. M.

O2
PATIENT

RES. BAG

NON REBREATH. M.
O2
100% OXYGEN

RESE. B. PATIENT

Non-Rebreather masks achieve close to 100% oxygen by minimizing room air entrainment and by attaching a reservoir bag filled with 100% oxygen. The reservoir bag has a flap valve to block exhaled gas from entering. Exhaled gas is directed out the side ports with flap valves to block air entrainment on inspiration.

TRANS TRACHEAL CATHETER

BLENDED HUMIDIFIED OXYGEN/AIR SOURCE

The unconscious patient who "looks at heaven" will soon be going there. (--The supine unconscious patient is predisposed to airway obstruction.)

OXYGEN TOXICITY

R . O . P.
PULMONARY CARDIAC NEUROTOXICITY REPERFUSION INJURY FREE RADICLES MISCLENOUS

Prescription of oxygen

PaO2
>70
RED. 5%

ABG
50 TO 70

PaCO2

< 50
INC. 5%

PaCO2

NO CH.%

<60 >60
FIO2 >40 % ADD CPAP 6

PaO2 >70

50 TO 70

< 50
INC. 5%

pH

RED. 5%

NO CH.%

>7.2 <7.2

FIO2 < 30 % RED. CPAP 1 CM

FIO2 >50% CPAP 8 C.M. CONSIDER M.V.

RESPIRATION

GOOD DEEP R .
SAT 93 % SAT 94% SAT 92 FIO2 50%

POOR

CPAP 5 CPAP 8

M.V.

SAT 90 %

D
E A T H

EATH IS USUALLY
DUE TO THE PHYSI. DIST. CAUSED BY THE DIS. RATHER THAN THE DIS. PER SE...