Discover the importance of oxygen therapy and how an oxygen concentrator can benefit respiratory conditions like COPD. Learn about different oxygen supply systems, home oxygen therapy, and precautions to avoid adverse effects.
What is oxygen therapy?
Oxygen is the source of life. Humans, animals, and plants cannot live without oxygen. Humans breathe all the time, breathing gas into the lungs through the mouth and nose (the inhalation part of the ventilation process).
The lungs absorb oxygen into the blood and exchange carbon dioxide (ventilation) through gas exchange. The lungs exhale gas through the mouth and nose to the outside of the body (the exhalation part of the ventilation process).
O2 therapy: refers to a treatment method that increases arterial oxygen partial pressure (PaO2) and arterial oxygen saturation (SaO2), increases arterial oxygen content (CaO2), corrects hypoxia caused by various reasons, promotes tissue metabolism, and maintains the body's life activities.
Can you be allergic to oxygen?
Long-term inhalation of high-concentration oxygen above 65% may cause oxygen poisoning. It is characterized by changes in the lung parenchyma, manifested as discomfort, pain, burning sensation under the sternum, increased breathing, nausea, vomiting, irritability, and dry cough.
Preventive measures: Avoid long-term, high-concentration oxygen therapy, and dynamically observe the effect of oxygen therapy.
After inhaling high-concentration oxygen therapy, the nitrogen in the alveoli is replaced in large quantities. Once the bronchus is blocked, the oxygen in the alveoli is rapidly absorbed by the pulmonary circulation blood, causing inhalation atelectasis. It manifests as irritability, increased breathing and heart rate, increased blood pressure, and then difficulty breathing, cyanosis, and coma.
Preventive measures: Encourage patients to take deep breaths, cough more, and change their lying position and posture frequently to prevent secretion blockage.
It is seen in patients with type II respiratory failure. Inhaling high-concentration oxygen relieves the stimulating effect of hypoxia on breathing, aggravates the depression of the respiratory center, and even stops breathing.
Preventive measures: Patients with type II respiratory failure should be given low-concentration, low-flow (1-3L/min) continuous oxygen. In addition, there are side effects such as hyperplasia of posterior lens fibrous tissue and dryness of respiratory secretions.
In which conditions is oxygen therapy required?
Generally speaking, oxygen therapy can be started as long as the arterial oxygen partial pressure (PaO2) is lower than normal, but in practice, stricter standards are often adopted.
The American College of Chest Physicians (ACCP) recommends:
Cardiorespiratory arrest; hypoxemia (PaO2<60mmHg, SaO2<90%);
Low cardiac output and metabolic acidosis (HCO3 < 18 mEq/L);
Respiratory distress (R >24 bpm);
When inhaling air, PaO2 < 60 mmHg or SaO2 < 90% PaO2 or SaO2 is lower than the expected level; CO poisoning, etc., oxygen therapy needs to be carried out according to the doctor’s instructions.
What are the common oxygen therapy oxygen supply systems?
Oxygen supply systems include: low-flow oxygen supply devices (relative to the patient's peak inspiratory flow), and oxygen concentration is not precisely controlled. High-flow oxygen supply devices (relative to the patient's peak inspiratory flow), oxygen concentration is precisely controlled.
Hyperbaric oxygen therapy: oxygen therapy using pure oxygen in a closed environment above one absolute atmospheric pressure.
Low-flow oxygen supply devices include nasal cannulas or nasal plugs, simple masks, oxygen storage masks, etc.
High-flow oxygen supply devices include Venturi masks, high-flow humidified nasal oxygen therapy, and ventilators. Hyperbaric oxygen therapy requires professional equipment for treatment.
Oxygen therapies at home refer to long-term oxygen therapy implemented when patients return home after leaving the hospital environment. Generally, the nasal cannula is used for continuous low-flow oxygen inhalation.
The oxygen flow rate is 1-3L/minute, and excessive oxygen concentration should be avoided to avoid carbon dioxide retention. Long-term home oxygen therapy is recommended for people with chronic lung disease and hypoxemia. The effective indicators of oxygen therapy are reduced dyspnea, slower respiratory rate, reduced cyanosis, slower heart rate, and increased activity endurance.
For patients with COPD like Jack, oxygen therapy at home should last at least 6 months, with at least 15 hours of oxygen inhalation per day, and the target fingertip blood oxygen saturation of 88-92% to achieve a better oxygen therapy effect.
For patients with severe hypoxemia, oxygen therapy should be continued as long as possible. Some patients also believe that the noise of the oxygen concentrator affects sleep, so oxygen inhalation during sleep should not be reduced. Noise can be improved by purchasing an extended oxygen concentrator online and updating a low-noise oxygen concentrator.
A movable oxygen therapy device can be used when going out. For patients who do not have hypoxia at rest but develop hypoxia during exercise, or for patients with severe hypoxemia who need to go out, portable oxygen devices can be used to supplement oxygen during the patient's exercise and daily activities.
Does the higher the oxygen concentration, the better the effect?
Oxygen therapies is a medical practice. Too little is not enough to solve the symptoms, and too much may cause adverse reactions. Oxygen therapy has different treatment goals for different diseases. The purpose of reasonable oxygen therapy is not only to improve hypoxia but also to avoid possible side effects. Everyone knows that SpO2 below 88% causes hypoxia in the human body, but it is actually worse when SpO2 reaches 100%.
For COPD patients with common hypercapnia in the respiratory department, completely correcting hypoxia will bring the risk of worsening the disease. High blood oxygen partial pressure may inhibit breathing and increase the risk of hypercapnia, respiratory acidosis, and oxygen poisoning.
Therefore, the target value of blood oxygen saturation is 88% to 92%. For patients with myocardial infarction or stroke, if the blood oxygen saturation is between 90% and 92%, it is recommended not to start oxygen therapy, and if the blood oxygen saturation is ≥93%, it is strongly recommended not to start oxygen therapy.
Do we all need oxygen supplements?
Under normal physiological conditions, each of us can get enough oxygen by breathing on our own in the plains. Again, oxygen is a drug and should not be abused. Some healthy people may experience chest tightness, fatigue, discomfort, and physical decline in a long-term fatigue state.
In this case, self-testing blood oxygen may be completely normal. Therefore, healthy people cannot rely on long-term oxygen inhalation to refresh themselves. They should actively adjust their lifestyles, exercise moderately, stay up less late, and maintain a positive attitude towards life, which can have a good effect.
