Download - Oxygen Therapy - Dr. Satish Deopujari
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Oxygen therapy Dr.Deopujari
O2
36 A.T.P.
2 A.T.P.
L.ACID
BODY OXYGEN STORES ALL
SMALL AND IF DEPLETED
THEY ARE INSUFFICIENT TO
SUSTAIN LIFE FOR MORE
THAN FEW
MINUTES
RESP.
C.V.S.
C.N.S.
SEPS.
M.
O.
F.
Oxygen was first used as a
remedy for illness in 1783 in
France by Chaussier. In
December of 1907, it was
used in surgery on a woman
who had tremendous internal
damage. It was administered
directly into the abdomen
and marked recovery was
noted.
25
50%
60
90%
0
10
20
30
40
50
60
70
80
90
100
SO2
0 10 20 30 40 50 60 70 80 90 100 110
pO2(mm Hg)
O.D.CURVE
O.D.CURVE
0
20
40
60
80
100
120
0 10 20 30 40 50 60 70 80 90 100 110
PO2
SO
2
Rt..
HB% 12
SAT 100%
HB% 12
SAT 50%
HB 6 GR
SAT 100%
HB 13 GR
SAT 90%
PaO2 SATURATION
2
TISSUES
CaO2 = (SAT x Hb x 1 . 3 4 ) + .0 0 3(PaO2)
PaO2 / FiO2 Ratio or "P/F” Ratio
Another much friendlier method
( because it doesn't use the alveolar gas
equation) used to predict shunt.
Just like the name says, PaO2 is divided by
FiO2
Normal is 286; lower indicates a shunt.
CLINICAL D. OF HYPOXIA
DISPRAP. BRADY / TACHY .
ALTERED SENSORIUM / SEI.
SHOCK. G.I.BLEED
MULTISYSTEM INV.
ANTICIPATE HYPOXIA
ROVING EYES
UNRESPONSIVE PUPIL
• PERFUSION DEPNDENT
SAT. NOT CONTENT
SHAPE OF O.D.CURVE
HYPEROXIA NOT DIAG.
POSITION OF CURVE
ABNORMAL HEMOGLOBIN
VENTILATORY STATUS ?
P
U
L
S
E
0
X.
SIMPLE OX. MASK
FIO2 VARIABLE
30 TO 60 %
FEEDING PROBLEM
REBREATHING……
NASAL CANNULA
MAX FLOW……2LIT/MIN FIO2 DIF. TO CONTROL HUMIDI. NOT NEC. MOUTH / NOSE BREAT.?
NASOPHARYN. CATH.
OROPHARYNX….ANAT. RES. OCCL. OF DIST. OPENING. GASTRIC DISTENSION FIO2 DIFFICULT TO CONT. SECRETIONS CATHER MORE THAN 8 FR.
2
AIR ENTRAINMENT V.
PRE. O2 CONC. <50 %
T. FLOW WITH FIO2
NOISE LEVEL ++++
HUMIDIFICATION ?
24% 4lit 105
28 6 68
31 8 63
35 10 56
40 12 50
50 12 33
FI O2 O2/L/MIN FLOW
YOU
ALMOST
NEVER
NEED
100 %
OXYGEN
HEAD BOX
LOW
PRESSURE
OUTLET
OXYGEN CONCENTRATOR
PATIENT
O2
PARTIAL REBREATH. M.
RES. BAG
O2
NON REBREATH. M.
RESE. B.
PATIENT
100%
OXYGEN
Non-Rebreather masks achieve close to
100% oxygen by minimizing room air
entrainment and by attaching a
reservoir bag filled with 100% oxygen.
The reservoir bag has a flap valve to
block exhaled gas from entering.
Exhaled gas is directed out the side
ports with flap valves to block air
entrainment on inspiration.
TRANS
TRACHEAL
CATHETER
BLENDED
HUMIDIFIED
OXYGEN/AIR
SOURCE
The unconscious patient
who "looks at heaven"
will soon be going there.
(--The supine
unconscious patient is
predisposed to airway
obstruction.)
OXYGEN TOXICITY
R . O . P. PULMONARY
CARDIAC
NEUROTOXICITY
REPERFUSION INJURY
FREE RADICLES
MISCLENOUS
Prescription of oxygen
ABG PaO2
<60 >60
>7.2 <7.2
pH
PaCO2
FIO2 >40 % ADD CPAP 6
INC. 5% NO CH.% RED. 5%
>70 50 TO 70 < 50
PaO2 >70 50 TO 70 < 50
INC. 5% NO CH.% RED. 5%
FIO2 >50% CPAP 8 C.M.
FIO2 < 30 %
RED. CPAP 1 CM CONSIDER M.V.
PaCO2
RESPIRATION
GOOD DEEP R . POOR
SAT 93 % SAT 94%
SAT 92
SAT 90 %
FIO2 50%
CPAP 5
CPAP 8
M.V.
EATH IS USUALLY
DUE TO THE PHYSI.
DIST. CAUSED BY
THE DIS. RATHER
THAN THE DIS.
PER SE………...
D E
A
T
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