oxygen therapy

Download Oxygen therapy

Post on 07-Jul-2015

1.848 views

Category:

Education

1 download

Embed Size (px)

TRANSCRIPT

  • 1. BY ANAESTHESIOLOGY UNIT OXYGEN THERAPY

2.

  • What is oxygen?
  • Hypoxia /Hypoxemia
  • Indications for oxygen therapy
  • Oxygen delivery systems
  • Complications of oxygen therapy
  • Conclusions

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
  • -Shock
  • -Vasoconstrictio
  • 3.Anaemic hypoxia( decreased O2 carrying capacity in the blood)
  • -Anaemia

HYPOXIA 5.

  • -Carbon monoxide poisoning
  • 4.Histotoxic hypoxia( inability the tissue utilize available O2)
  • - Cyanide poisoning
  • Reduced O2 concentration/tension in the blood
  • PaO210LPM?
  • Advantages simple, light, deliver higher FiO2
  • Disadvantages need to remove for eat, drink, speak
  • -uncomfortable for facial trauma

12.

  • 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
  • 7LPM0.65
  • 8-15LPM0.70-0.80
  • Non rebreathing
  • Flow FiO2
  • Set to prevent collapse of bag0.85-1.0

13.

  • 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
  • FlowFiO2
  • 40.24
  • 60.28
  • 80.35-0.40
  • 120.60

14.

  • 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

16.

  • Fire
  • O2 support combustion
  • Do not smoke while receiving O2 therapy

17.

  • Patient on Chemotherapy
  • Patient on chemotherapy especially bleomycin will develop pulmonary fibrosis if get excessive O2 therapy

18.

  • O2 can be store either
  • 1)Cylinder
  • 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

19. 20.

  • 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

21. 22.

  • 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