Oxygen Therapy
Oxygen therapy is used either short-term for people who are recovering from acute lung disorders or longer for people with chronic lung disorders in whom oxygen levels are consistently low. Oxygen therapy is used in the hospital not only for people with chronic lung disorders, but also for people with acute lung disorders, such as pneumonia, or conditions that temporarily benefit from maintaining a higher level of oxygen in the blood, such as angina (a condition in which the heart muscle is not receiving enough oxygen) (see Section 3, Chapter 33).
The use of therapeutic oxygen improves survival in people with chronic lung disease who consistently have low levels of oxygen in their blood. The more hours a day the oxygen is used, the better the result. Survival is better when 12 hours of oxygen are used than when no oxygen is used; survival is even better when oxygen is used continuously (24 hours per day). Other benefits of long-term oxygen use include a reduction on the strain of the heart that lung disease causes and less shortness of breath. Both sleep and the ability to exercise tend to improve.
Some people with chronic lung disease have low levels of oxygen only when they physically exert themselves. These people can limit their oxygen use to periods of exertion. Other people have low levels only when they are sleeping. These people can limit their oxygen use to overnight hours.
Once the critical level of oxygen is determined, oximetry may be used to adjust oxygen flow settings over time (see Section 4, Chapter 39). Oximetry is painless and uses a simple finger or ear device to measure the amount of oxygen in the blood.
Long-term home oxygen is available from three different delivery systems: electrically driven oxygen concentrators, liquid systems, and compressed gas. Inside the home, liquid and compressed gas systems use large tanks to store oxygen. Small, portable tanks of compressed oxygen also may be needed for brief periods---a few hours--outside the home. Each system has advantages and disadvantages. Oxygen is typically administered with continuous flow through a 2-pronged nasal tube (cannula), even though this system is highly wasteful of oxygen. To improve efficiency and increase the person's mobility, several devices, including reservoir cannulas, demand-type systems, and transtracheal catheters, can be used. Usually, a respiratory therapist or physician instructs the person about proper oxygen use.
While using oxygen therapy at home, it is important to stabilize the tank (possibly using a stand) and store it in an area that is out of the way so it will not fall. The tank should be closed tightly when not in use. Because oxygen can cause an explosion, it is also important to be careful to keep the tank away from any flammable source, such as matches, heaters, or hair dryers. No one in the house should smoke when oxygen is in use.
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