Diferencia entre revisiones de «Oxygen therapy»
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==Standard Administration Options== | |||
{| class="wikitable" | {| class="wikitable" | ||
| align="center" style="background:#f0f0f0;"|'''Device''' | | align="center" style="background:#f0f0f0;"|'''Device''' | ||
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| Oxygen tent||10-15||21-50%||Used mainly on children with croup or pneumonia | | Oxygen tent||10-15||21-50%||Used mainly on children with croup or pneumonia | ||
|- | |- | ||
| Simple mask||5- | | Simple mask||5-15||35-55%||Never used at flows less than 5 L/min to prevent rebreathing of CO2 | ||
|- | |- | ||
| Trach mask||10-15||35-60%||Adequate flow shown by mist flowing out the exhalation port at all times | | Trach mask||10-15||35-60%||Adequate flow shown by mist flowing out the exhalation port at all times | ||
| Línea 31: | Línea 33: | ||
| Non-rebreathing mask||8-15 (or max)||60-99%||Flow rate must be sufficient to keep bag 1/3 to 1/2 inflated at all times | | Non-rebreathing mask||8-15 (or max)||60-99%||Flow rate must be sufficient to keep bag 1/3 to 1/2 inflated at all times | ||
|} | |} | ||
==High-flow Nasal Cannula== | |||
*Different Setup to low-flow O2 therapy | |||
*Good for hypoxemic respiratory failure | |||
*Every 10L/min is similar to 1mmHg PEEP | |||
*Set flow and FiO2% | |||
*Adults | |||
**Flow - start with 0.5 L/kg/min (Max 60L) | |||
**FiO2 - start with 100% and taper down from there | |||
*Pediatrics | |||
**FiO2 - Start 40% and titrate up | |||
**Flow - based on weight (table below) <ref> Richards-Belle A, Davis P, Drikite L, et al FIRST-line support for assistance in breathing in children (FIRST-ABC): a master protocol of two randomised trials to evaluate the non-inferiority of high-flow nasal cannula (HFNC) versus continuous positive airway pressure (CPAP) for non-invasive respiratory support in paediatric critical care BMJ Open 2020;10:e038002. doi: 10.1136/bmjopen-2020-038002 PDF: https://bmjopen.bmj.com/content/bmjopen/10/8/e038002.full.pdf</ref>. | |||
{| class="wikitable" | |||
|- | |||
! Weight (kg) !! <=12!! 13-15!! 16-30!! 31-50 !! >50 | |||
|- | |||
| Starting flow rate || 2 l/min/kg || 25-30 l/min || 35 l/min|| 40 l/min || 50 l/min | |||
|} | |||
==Hyperbaric Oxygen (HBO)== | |||
*Two methods of administration<ref name="Bitterman">Bitterman H. Bench-to-bedside review: Oxygen as a drug. Critical Care. 2009;13(1):205. doi:10.1186/cc7151.</ref> | |||
*#Small, single-occupant chamber filled with 100% oxygen and pressurized to desired level | |||
*#Large, multi-occupant chamber filled with room air and pressurized to desired level - occupants breathe supplemental oxygen at ambient pressure via mask | |||
*Rationale for use<ref name="Bitterman" /> | |||
**At normal pressures (even with supplemental oxygen administration), very little oxygen is dissolved in plasma | |||
**When oxygen provided at 3 ATA, there is enough oxygen dissolved in plasma to oxygenate all body tissues without resorting to hemoglobin-bound oxygen | |||
==See Also== | ==See Also== | ||
*[[Oxygen toxicity]] | *[[Oxygen toxicity]] | ||
*[[High altitude medicine]] | |||
==External Links== | ==External Links== | ||
Revisión actual - 11:26 28 feb 2021
Standard Administration Options
| Device | L/min | % Oxygen | Comments |
| Nasal Cannula | 1 | 24% | |
| 2 | 28% | ||
| 3 | 32% | ||
| 4 | 36% | ||
| 5 | 40% | ||
| 6 | 44% | ||
| Venturi mask | 24-50% | Increasing flow will not alter FiO2 | |
| Oxygen tent | 10-15 | 21-50% | Used mainly on children with croup or pneumonia |
| Simple mask | 5-15 | 35-55% | Never used at flows less than 5 L/min to prevent rebreathing of CO2 |
| Trach mask | 10-15 | 35-60% | Adequate flow shown by mist flowing out the exhalation port at all times |
| Partial rebreathing mask | 8-15 | 35-60% | Flow rate must be sufficient to keep bag 1/3 to 1/2 inflated at all times |
| Aerosol mask | 8-15 | 21-99% | |
| Non-rebreathing mask | 8-15 (or max) | 60-99% | Flow rate must be sufficient to keep bag 1/3 to 1/2 inflated at all times |
High-flow Nasal Cannula
- Different Setup to low-flow O2 therapy
- Good for hypoxemic respiratory failure
- Every 10L/min is similar to 1mmHg PEEP
- Set flow and FiO2%
- Adults
- Flow - start with 0.5 L/kg/min (Max 60L)
- FiO2 - start with 100% and taper down from there
- Pediatrics
- FiO2 - Start 40% and titrate up
- Flow - based on weight (table below) [1].
| Weight (kg) | <=12 | 13-15 | 16-30 | 31-50 | >50 |
|---|---|---|---|---|---|
| Starting flow rate | 2 l/min/kg | 25-30 l/min | 35 l/min | 40 l/min | 50 l/min |
Hyperbaric Oxygen (HBO)
- Two methods of administration[2]
- Small, single-occupant chamber filled with 100% oxygen and pressurized to desired level
- Large, multi-occupant chamber filled with room air and pressurized to desired level - occupants breathe supplemental oxygen at ambient pressure via mask
- Rationale for use[2]
- At normal pressures (even with supplemental oxygen administration), very little oxygen is dissolved in plasma
- When oxygen provided at 3 ATA, there is enough oxygen dissolved in plasma to oxygenate all body tissues without resorting to hemoglobin-bound oxygen
See Also
External Links
References
- ↑ Richards-Belle A, Davis P, Drikite L, et al FIRST-line support for assistance in breathing in children (FIRST-ABC): a master protocol of two randomised trials to evaluate the non-inferiority of high-flow nasal cannula (HFNC) versus continuous positive airway pressure (CPAP) for non-invasive respiratory support in paediatric critical care BMJ Open 2020;10:e038002. doi: 10.1136/bmjopen-2020-038002 PDF: https://bmjopen.bmj.com/content/bmjopen/10/8/e038002.full.pdf
- ↑ 2.0 2.1 Bitterman H. Bench-to-bedside review: Oxygen as a drug. Critical Care. 2009;13(1):205. doi:10.1186/cc7151.