Diferencia entre revisiones de «Oxygen toxicity»
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==Background== | ==Background== | ||
* | *The harmful effects of breathing oxygen at higher partial pressures than normal | ||
**Partial pressure of O2 at sea level = 0.21 ATA | |||
*Toxicity based on both time and partial pressure of oxygen | |||
**Generally, FiO2 of 40% or less (0.40 ATA) can be tolerated indefinitely<ref name="Hedley">Hedley-Whyte J. Pulmonary Oxygen Toxicity: Investigation and Mentoring. The Ulster Medical Journal. 2008;77(1):39-42.</ref> | |||
**Most common in hyperbaric oxygen therapy and prolonged administration of normobaric supplemental oxygen | |||
**Pulmonary toxicity occurs sooner and at lower partial pressures than CNS toxicity<ref name="Hedley" /> | |||
==Clinical Features== | ==Clinical Features== | ||
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==Management== | ==Management== | ||
* | *Lower inhaled partial pressure of oxygen to as low as tolerated while maintaining tissue perfusion<ref name="Deutschman">Deutschman, C. S., & Neligan, P. J. (2010). Evidence-based practice of critical care. Philadelphia, PA: Saunders/Elsevier.</ref> | ||
==Disposition== | ==Disposition== | ||
Revisión del 03:41 5 mar 2016
Background
- The harmful effects of breathing oxygen at higher partial pressures than normal
- Partial pressure of O2 at sea level = 0.21 ATA
- Toxicity based on both time and partial pressure of oxygen
Clinical Features
Pulmonary
- Tracheobronchial irritation → pleuritic chest pain, dyspnea and coughing[2]
- Atelectasis
- Diffuse alveolar damage → Pulmonary edema/ARDS
Central nervous system
- Tunnel vision
- Tinnitus
- Nausea
- Facial twitching
- Irritability (personality changes, anxiety, confusion, etc.)
- Seizure
Ocular
- Retinopathy of prematurity (retrolentar fibroplasia)
- Seen in premature infants
- In adults exposed to repeated toxic levels of oxygen, can get hyperoxic myopia[3]
- Resolves spontaneously over several weeks
Differential Diagnosis
Diving Emergencies
- Barotrauma of descent
- Otic barotrauma
- Pulmonary barotrauma
- Sinus barotrauma
- Mask squeeze
- Barodentalgia (trapped dental air causing squeeze)
- Barotrauma of ascent
- Pulmonary barotrauma (pulmonary overpressurization syndrome)
- Decompression sickness (DCS)
- Arterial gas embolism
- Alternobaric vertigo
- Facial baroparesis (Bells Palsy)
- At depth injuries
- Oxygen toxicity
- Nitrogen narcosis
- Hypothermia
- Contaminated gas mixture (e.g. CO toxicity)
- Caustic cocktail from rebreathing circuit
Diagnosis
- Clinical diagnosis
Management
- Lower inhaled partial pressure of oxygen to as low as tolerated while maintaining tissue perfusion[4]
Disposition
- Admit
See Also
External Links
References
- ↑ 1.0 1.1 Hedley-Whyte J. Pulmonary Oxygen Toxicity: Investigation and Mentoring. The Ulster Medical Journal. 2008;77(1):39-42.
- ↑ Thomson L, Paton J. Oxygen toxicity. Paediatr Respir Rev. 2014 Jun;15(2):120-3.
- ↑ Anderson B, Farmer JC. Hyperoxic myopia. Transactions of the American Ophthalmological Society. 1978;76:116-124.
- ↑ Deutschman, C. S., & Neligan, P. J. (2010). Evidence-based practice of critical care. Philadelphia, PA: Saunders/Elsevier.