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Oxygen Therapy

Hasanul Arifn

epartemen Anestesiologi dan Terapi Intensi

FKUSU-RSUP. H. Adam Mali Medan.

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Introduction

• T!e un"tion o respiration is to pro#ide an

ade$uate suppl% o &' to t!e pulmonar%

"apillaries

and remo#e (&' rom t!e al#eoli.• ' prin"ipal purposes)

- to maintain ade$uate arterial Pa&'* and

- to regulate arterial Pa(&'

maintain a sta+le a"id,+ase state.

• ot! are ne"essar% to sustain normal tissuemeta+olism.

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Defnition

• &' t!erap% is t!e administration o &'

at "on"entrations greater t!an t!atin am+ient air it! t!e intent otreating or pre#enting t!e s%mptoms

and maniestations o !%po/ia.

R0SPIRAT&R1 (AR0 2 3U40 '55' 6&7 89 4& :

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• H%po/emia Pa&' in t!e +lood +elonormal range. Pa&' ;< :5 mmHg or Sa&' o < =5> in su+?e"ts +reat!ing room air or

it! Pa&' and@or Sa&' +elo desira+lerange or spe"if" "lini"al situation.

• Se#ere trauma

• A"ute m%o"ardial inar"tion

• S!ort-term t!erap% or surgi"al inter#ention;eg* post-anest!esia re"o#er%* !ip surger%

Indications

R0SPIRAT&R1 (AR0 2 3U40 '55' 6&7 89 4& :

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O2 Delivery Devices Low-Flow

Devices

a. 4asal "annulas+. Simple a"e mas". Partial Re+reat!ing masd. 4onore+reat!ing mas

O2 Delivery Devices High-Flow

Devices

a. 6enturi mass+. Hig!-Bo nasal "annulas

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Manageent

• A"ute respirator% ailure CA( ;CAira%* reat!ing* (ir"ulation

approa"!

E !ig!-Bo &' t!erap% ;G 7@min #ia aa"emas

ftted it! a reser#oir +ag.

• I t!e patient is not alert and responsi#e ma/imie aira% paten"%

, a ?a t!rust manoe#re or

, orop!ar%ngeal aira%

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!tandard nasal cannula

• Deli#ers Fi&' '8,85> at Bos ,G

7@min.

• T!e ormula

Fi&' J '5> E ;8 &' 7 Bo.

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Appro/imate FI&' Deli#ered +% 4asal(annula

Flo Rate ;7@min Appro/imateFI&'L

5.'8' 5.'

N 5.N'

8 5.N:G 5.85

: 5.88FIO2* Fra"tion o inspired o/%gen

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High "oncentration #eservoir Mas$

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• T!e #olume 55,N55 m7.

• It deli#ers Fi&' 85,:5> at G,5 7@min.

• Is indi"ated in patients it! nasal irritationor epista/is.

• Useul or patients !o are stri"tl% mout!+reat!ers.

• &+trusi#e* un"omorta+le* "onfning*muOes "ommuni"ation* o+stru"ts"oug!ing* and impedes eating.

!iple Face Mas$

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Appro/imate Fi&' Deli#ered +% Simple Fa"e Mas

Flo Rate ;7@min Fi&'L

G,: 5.8

:,9 5.G9, 5.:

FiO2* Fra"tion o inspired o/%gen

!iple Face Mas$

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%onre&reathing 'ace as$with reservoir and one-way

valve

• Indi"ated !en Fi&' 85> is re$uired.

• Deli#er Fi&' =5> at !ig! Bo settings.

• &' Bos into t!e reser#oir at ,5 7@min*

as!ing t!e patient it! a !ig!"on"entration o &'.

• Its ma?or dra+a" is t!at t!e mas must+e tig!tl% sealed on t!e a"e* !i"! isun"omorta+le.

• T!ere is also a ris o (&' retention.

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%onre&reathing 'ace as$with reservoir and one-way

valve

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#eservoir cannulas

• Impro#e t!e eQ"ien"% o &' deli#er%.

• ell o/%genated at loer Bos.

• &' 7@min ade$uatel% o/%genate

patients it! a !ig! Bo re$uirement

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(ir )ntrainent Mas$s *+enturi Mas$,

• Mi/es &' it! room air

!ig!-Bo enri"!ed&' o a setta+le"on"entration.

• A""urate and "onstant Fi&'.• Fi&' deli#er% settings

'8* '* N* NG* 85>.

• Is oten emplo%ed !en"on"ern (&' retention.

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Noninvasive ventilation (NIV) refers to the delivery of

mechanical ventilation to the lungs using techniques that

do not require an endotracheal airway.

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TH(% .O/ FO#

LI!T)%I%0

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