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- 1. BY ANAESTHESIOLOGY UNIT OXYGEN THERAPY
- What is oxygen?
- Hypoxia /Hypoxemia
- Indications for oxygen therapy
- Oxygen delivery systems
- Complications of oxygen therapy
Oxygen therapy 3.
- Oxygen is a gaswith chemical formula of O2
- Colourless, odorless, tasteless
- Boiling point-183 C
- Melting point 216.6C
- Critical temp. 118.4C, Critical pressure 736.9psi
- Constitutes about 20.95% of atmosphere
- Used at cellular level as the final electron acceptor in the electron transport chain in the mitochondria of cell
WHAT IS OXYGEN? 4.
- Inadequate delivery of O2 to the tissue
- Type of hypoxia
- 1.Hypoxic hypoxia( decrease diffusion of O2 across the alveolar-capillary membrane
- -low inspired FiO2
- -V/Q inequalities
- -increased shunt(eg cardiac anomalies)
- 2.Stagnant hypoxia(decreased cardiac output resulting in increased systemic transit time
- 3.Anaemic hypoxia( decreased O2 carrying capacity in the blood)
- -Carbon monoxide poisoning
- 4.Histotoxic hypoxia( inability the tissue utilize available O2)
- - Cyanide poisoning
- Reduced O2 concentration/tension in the blood
- Advantages simple, light, deliver higher FiO2
- Disadvantages need to remove for eat, drink, speak
- -uncomfortable for facial trauma
- Partial rebreathing and Non rebreathing mask
- Similar to simple mask with addition of the O2 reservoir
- to increase FiO2 greater than 0.60
- Non rebreathing mask one way valve to prevent rebreathing
- Partial rebreathing
- Flow FiO2
- Non rebreathing
- Flow FiO2
- Set to prevent collapse of bag0.85-1.0
- Venturi mask
- Operate onBernoulli principle
- - As gas flow under pressureat rapid flow rate an area ofpressure develops lateral to the small opening and lead to entrainment of room air through the side port.
- Advantages delivery of very predictable FiO2
- -may use in COAD patient
- Disadvantages same like face mask
- Hypoventilation and Carbon Dioxide Narcosis
- the increased PO2 decreased and eliminates the hypoxic drive ( esp. in pt. with chronic CO2 retention )
- Under this circumstances O2 must be given at low concentration 50% for prolonged period shows increased O2 toxicity
- Pulmonary changes mimic ARDS (Exudative changes and proliferative changes.)
- Sx cough, burning discomfort, nausea and vomiting, headache, malaise and etc
- Retrolental Fibroplasia
- Excessive O2 to pre-mature infants may result in constriction of immature retinal vessels, endothelial damage, retinal detachment and possible blindness
- Recommended that PO2 be maintained between 60-90 mmHg range in neonate
- O2 support combustion
- Do not smoke while receiving O2 therapy
- Patient on Chemotherapy
- Patient on chemotherapy especially bleomycin will develop pulmonary fibrosis if get excessive O2 therapy
- O2 can be store either
- Oxygen can be stored under pressure in cylinders made of molybdenum steel.
- Cylinders are black with white shoulders.
- The pressure inside at 15C is 137 bar.
- 2)Oxygen concentrators
- An oxygen concentrator is a device which extracts oxygen from atmospheric air using canisters
- Nitrogen is filtered out and oxygen produced.
- 3)Vacuum Insulated Evaporator (VIE) .
- Designed to store liquid oxygen.
- It consists of two layers, where the outer carbon steel shell is separated by a vacuum from an inner stainless steel shell, which contains the oxygen
- The oxygen temperature is -170 C at 10.5 atm.
- The VIE system is used in large hospitals which have a pipeline system, and where liquid oxygen can be supplied by road tanker
- O2 therapy is the delivery of any O2 conc. Greater then 21%
- The need for O2 should be determined through the thorough evaluation
- One must consider advantages and disadvantages when choosing the appropriate technique
- No procedure without complication
Conclusions 23. Thank you