OXYGEN THERAPY

Introduction

SaO2 93% (~ pO2 70mmHg)

SaO2 90% (~ pO2 60mmHg)

Aim to keep SaO2 > 93%

Oxygen delivery devices

In order of increasing levels of oxygen delivery (FiO2):

Rapidly increase oxygen delivery (every 30 sec) until satisfactory SaO2 or pO2 is obtained

N.B. in cases of known CO2 retention - aim for SaO2 90-93% (pO2 60-70mmHg) - this should prevent excessive increase in CO2

Remember, hypoxia kills faster than hypercarbia!

If you cannot achieve adequate oxygenation with above then consider CPAP/mechanical ventilation

COMPLICATIONS

Acute

• Hypercarbia (from Worsening V/Q mismatching/Haldane effect - NOT from depressed respiration from hypoxic drive - this is a MYTH)

Subacute

• Pulmonary toxicity (with 100% FiO2 > 24 hrs)
• Retrolental fibroplasia (in neonates)

see Hyperbaric oxygen therapy

see CPAP

see Mechanical ventilation