Oxygen therapy
Standard Administration Options
| Device | L/min | % Oxygen | Comments |
| Nasal Cannula | 1 | 24% | |
| 2 | 28% | ||
| 3 | 32% | ||
| 4 | 36% | ||
| 5 | 40% | ||
| 6 | 44% | ||
| Venturi mask | 24-50% | Increasing flow will not alter FiO2 | |
| Oxygen tent | 10-15 | 21-50% | Used mainly on children with croup or pneumonia |
| Simple mask | 5-15 | 35-55% | Never used at flows less than 5 L/min to prevent rebreathing of CO2 |
| Trach mask | 10-15 | 35-60% | Adequate flow shown by mist flowing out the exhalation port at all times |
| Partial rebreathing mask | 8-15 | 35-60% | Flow rate must be sufficient to keep bag 1/3 to 1/2 inflated at all times |
| Aerosol mask | 8-15 | 21-99% | |
| Non-rebreathing mask | 8-15 (or max) | 60-99% | Flow rate must be sufficient to keep bag 1/3 to 1/2 inflated at all times |
High-flow Nasal Cannula
- Different Setup to low-flow O2 therapy
- Good for hypoxemic respiratory failure
- Every 10L/min is similar to 1mmHg PEEP
- Set flow and FiO2%
- Adults
- Flow - start with 0.5 L/kg/min (Max 60L)
- FiO2 - start with 100% and taper down from there
- Pediatrics
- FiO2 - Start 40% and titrate up
- Flow - based on weight (table below) [1].
| Weight (kg) | <=12 | 13-15 | 16-30 | 31-50 | >50 |
|---|---|---|---|---|---|
| Starting flow rate | 2 l/min/kg | 25-30 l/min | 35 l/min | 40 l/min | 50 l/min |
Hyperbaric Oxygen (HBO)
- Two methods of administration[2]
- Small, single-occupant chamber filled with 100% oxygen and pressurized to desired level
- Large, multi-occupant chamber filled with room air and pressurized to desired level - occupants breathe supplemental oxygen at ambient pressure via mask
- Rationale for use[2]
- At normal pressures (even with supplemental oxygen administration), very little oxygen is dissolved in plasma
- When oxygen provided at 3 ATA, there is enough oxygen dissolved in plasma to oxygenate all body tissues without resorting to hemoglobin-bound oxygen
See Also
References
- Richards-Belle A, Davis P, Drikite L, et al FIRST-line support for assistance in breathing in children (FIRST-ABC): a master protocol of two randomised trials to evaluate the non-inferiority of high-flow nasal cannula (HFNC) versus continuous positive airway pressure (CPAP) for non-invasive respiratory support in paediatric critical care BMJ Open 2020;10:e038002. doi: 10.1136/bmjopen-2020-038002 PDF: https://bmjopen.bmj.com/content/bmjopen/10/8/e038002.full.pdf
- Bitterman H. Bench-to-bedside review: Oxygen as a drug. Critical Care. 2009;13(1):205. doi:10.1186/cc7151.
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