What is oxygen therapy?

Indications and Procedures

The major indication for oxygen therapy is cyanosis, in which the skin assumes a bluish tint as a result of hypoxia, a reduced arterial saturation of oxygen to the tissues. In cases of extreme breathlessness, which may be caused by extreme physical exertion, hypoxia may occur, but the condition in most cases reverses itself within minutes if the affected person rests.

In older people whose circulatory systems have been compromised by such conditions as arteriosclerosis (narrowing of the arteries), hypoxia may be chronic. Asthmatics often require immediate oxygen therapy during severe attacks. People suffering from influenza or pneumonia may have accumulated secretions in their airways that limit the amount of oxygen that can reach their tissues. Such people are usually given oxygen administered through either a nasal catheter or a face mask.

In instances where respiratory difficulties persist, as in emphysema
or chronic bronchitis, patients often receive prescriptions for oxygen cylinders for home use. They may also benefit from the home installation of an oxygen concentrator, a machine that removes oxygen from the atmosphere and remixes it in high concentrations with air. Such machines can supply oxygen-enhanced air to various rooms within a house so that ambulatory patients can breathe it for prolonged periods without being confined to one location. Some patients must breathe oxygen-enhanced air for up to fifteen hours a day.

Uses and Complications

Oxygen therapy is routinely used by anesthesiologists during many surgical procedures, but very high oxygen concentrations are usually avoided. Warm, humidified oxygen is preferred in surgical situations to prevent condensation and inordinate cooling, which can lead to complications. Such therapy is often administered through a catheter and used postoperatively for up to five days to prevent hypoxemia (reduced oxygen in the blood). In emergency rooms, pure oxygen is frequently given to patients in acute distress.

In some situations, physicians must use medications such as naftidrofuryl to reduce the brain’s requirement for oxygen where hypoxemia is present, and brain damage may result if this complication is not addressed immediately. A thrombus (blood clot) may reduce blood flow substantially and reduce to dangerous levels the supply of oxygen to the brain and tissues. In such situations, anticoagulants such as heparin or warfarin often reduce or eliminate the thrombus and restore the body’s circulation of oxygen.

Bibliography

Perry, Anne Griffin, and Patricia A. Potter, eds. Clinical Nursing Skills and Techniques. 6th ed. St. Louis, Mo.: Mosby/Elsevier, 2006.

Rosdahl, Caroline Bunker, and Mary Kowalski, eds. Textbook of Basic Nursing. 9th ed. Philadelphia: Lippincott Williams & Wilkins, 2008.

Sheldon, Lisa Kennedy. Oxygenation. 2d ed. Sudbury, Mass.: Jones and Bartlett, 2008.

Tallis, Raymond C., and Howard M. Fillit, eds. Brocklehurst’s Textbook of Geriatric Medicine and Gerontology. 7th ed. Philadelphia: Saunders/Elsevier, 2010.