O2 THERAPY

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O2 THERAPY
Dr . Zienb EL Matary
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O2 THERAPY

• O2 is a drug, it has dose, duration of
  action,indications and contraindications
• O2 may save the life of the patient or if used
  wrongly may kill the patient.
• O2 is used on cases of R.F.

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Respiratory failure

• It is failure of the lung to give metabolic
  requirement for the individual.
• It may be known by measuring pa o2, pa co2 if pa
  o2 ? 56 or 60 and Pa co2? 49

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Types of R.F

• Type I in which PaO2 and normal or PaCO2.
• Type II in which PaO2 and Pa CO2.

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C / P of R.F of hypoxia

• - Dyspnea which is variable, It is very apparent
  in bronch. Asthma while may be not so apparent in
  C.O.P.D according to chronicity.

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• Cyanosis except in anemia
• Irritability
• Intellectual function
• Convulsions and comma
• Stimulation of chemoreceptors
• H.R
• C.O.P
• Arrhythmias
• Especially with digitalis or duritics.

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C P of hypercapnia

• Warm extremities
• Flappy tremors
• I.C.T
• Bounding pulse
• Headach
• Drowsy and comma
• C/P is variable and better to be diagnosed by
  A.B.G

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TypeI .R.F
Chronic
ACUTE
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Causes of acute typeI .R.F

• Acute severe asthma . .(type II in asthma is life
  threatening).
• L.V.F and pulm. Oedema.
• Pulm. Embolism.
• Severe pnumonia.

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Here we can give high concetration O2
We can be given by a. Nasal bronge advantage
- easy to use Disadvantage- it give uncontroled
O2 -cant be used on mouth breather -Cant be
used on injured nose or deviated septum. b. O2
mask although It is difficult for patient but
it gives controled O2, it may CO2 level so used
in severe hyperventilation and Resp. alkalosis to
CO2 level especialy mask with bag. c. O2 tent but
very expensive - treatment of underlying cause
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Chronic typeI. R.F it found in

• Emphysema
• Lung fibrosis all its types
• Anemia
• -high flow O2 is used to achive acceptable PaO2
  level.to reach the level of PaO2 60
• - treatment of type I Resp.failure

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- treatment of type I Resp.failure

• .O2 therapy.
  
• .Treatment of the cause.
  
• .If failed to control the patient mechanical
  ventilation.
  

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Type II R.F

• ACUTE - it is dangerous as it may
  acute rise in CO2 Resp. acidosis
• -causes include - flail chest
• -laryngeal oedema
• -forign body inhalation
• -Narcotic drugs

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Chronic - C.O.P.D

• Chronic CO2 rise kidny compensation
  by HCO3 formation so PH is within normal .
• - main derive of stimulation of respiration is
  hypoxia not CO2 level . So rapid treatment of
  hypoxia inhibit the hypoxie derive
  depression of R.C more of CO2 and more
  hypoxia .
• The detorioation of the condition is mainly due
  to
• Acute excerbation
• Core pulmonale
• pnumothorax

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Treatment

• Controlled o2 by high flow V.M oxygenation, start
  by lowest one.
• treatment of the cause (suckion, infection,core
  pulmonale, pnumotherax).
• - if still unconcious and rising of co2
  mechanical ventilation.
• We can ventilation the patient on
• Concious level.
• P.H.
• O2level.
• Co2 level.

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-O2 on mechanical ventilation by Endo-tracheal
tube - difficult to introduce, needs training-
in case of short neek, kyphschiosis, non trained
person we can use combi tube and laryngal mask.
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Thank you