Oxygen Therapy for Impaired Gas Exchange

Introduction

Oxygen therapy is essential for patients with impaired gas exchange.
Delivered through various routes: nasal cannula, simple mask, partial rebreather, non-rebreather, and Venturi mask.
Focus on key nursing considerations for each type.

Occurs in respiratory or cardiac issues, leading to hypoxemia (low blood oxygen).
Causes: sepsis, fever, anemia.

Nasal Cannula
- Rate: 1-6 L/min (typically max 4 L/min with humidifier).
- Maintain oxygen saturation >92% (not applicable for COPD patients).
- FiO2 increases by 4% with each additional liter.
- Assess via ABG, pulse oximeter, and capnography (35-45 mmHg).
Simple Mask
- Covers nose and mouth, allows exhalation through ports.
- Oxygen range: 40-60%; 5-8 L/min.
- Used post-surgery or rapid oxygenation change.
- Watch for respiratory distress signs.
Partial Rebreather
- Delivers 6-11 L/min, 60-75% FiO2.
- Rebreathes one-third of exhaled volume.
- Ensure bag is inflated, and watch for kinks.
- Monitor patient history for risk factors.
Non-Rebreather
- Delivers 10-15 L/min, highest in low flow systems.
- Exhalation ports with flaps to prevent room air entry.
- Risk of oxygen toxicity if >50% for 24-48 hours.

High Flow Nasal Cannula
- Delivers 30-60 L/min with heat and humidity.
- Reduces mucous membrane damage and infection risk.
Venturi Mask
- Provides specific FiO2 (24-50%).
- Used for hypoxic drive patients like those with COPD.
- Contains color-coded orifice for exact oxygen delivery.
Non-Invasive Positive Pressure Ventilation (NPPV)
- Used for COPD, hypercarbia, acute asthma, or dyspnea.
BiPAP and CPAP
- BiPAP: set inspiratory pressure assists breathing.
- CPAP: keeps alveoli expanded, prevents re-intubation.