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Oxygen Delivery and Its Importance in Critical Care

Jul 15, 2024

Oxygen Delivery and Its Importance in Critical Care

Introduction

  • Oxygen: Vital for cellular respiration and ATP production.
  • Hypoxia: Risk of impaired ATP production, affecting high-consuming organs like the brain and heart.
  • Monitoring: SPO2 as a primary metric.

About ICU Advantage

  • Instructor: Eddie Watson.
  • Objective: Simplifying complex critical care subjects for ICU success.
  • Resources: Lesson notes available via YouTube and Patreon memberships.

Cellular Respiration and Oxygen

  • Function: Breakdown of glucose, lipids, and proteins for energy via the electron transport chain.
  • ATP Production: Oxygen is critical for maximizing ATP output.

Oxygen Delivery Devices

  • Aim to understand various devices and their uses based on patient needs.

Non-Invasive Devices

Low-Flow Devices

1. Nasal Cannula

  • Usage: Common for low oxygen needs.
  • Details: 1-6 liters/min (24-44% FiO2).
  • Considerations: Humidification for flows ā‰„ 4 liters/min; not suitable for heavy mouth breathers.

2. Simple Mask

  • Usage: Basic mask covering nose and mouth.
  • Details: 6-12 liters/min (35-50% FiO2).
  • Special Features: Nebulizer attachment for med delivery; requires minimum 6 liters/min to prevent CO2 re-breathing.

3. Venturi Mask

  • Usage: Precise oxygen concentrations.
  • Details: 4-12 liters/min (24-60% FiO2).

4. Trach-Related Devices

  • Types: T-piece, trach collar, trach shield.
  • Usage: Non-invasive delivery around trach opening; must be humidified.

5. Face Tent

  • Usage: Alternative to masks for patients intolerant to other devices.
  • Function: Blows oxygen around patientā€™s face.

6. Rebreather Masks

  • Types: Partial and Non-Rebreather.
  • Details: Partial: 6-10 liters/min (35-60% FiO2); Non-Rebreather: 6-15 liters/min (up to ~95% FiO2).
  • Usage: Non-Rebreather for emergency high oxygen needs.

7. Bag-Valve Mask

  • Usage: Emergency resuscitation; delivers 100% oxygen at 15 liters/min.

High-Flow Devices

1. High-Flow Nasal Cannula

  • Details: Up to 40-60 liters/min, up to 100% FiO2.
  • Considerations: Must be humidified and temperature controlled.

2. CPAP/BiPAP

  • Usage: Positive pressure support; used to avoid intubation in some conscious patients.

Invasive Devices

1. Ventilator

  • Usage: Requires intubation; full control over breaths and oxygen delivery.
  • Capacity: Up to 100% FiO2.

2. ECMO (Extracorporeal Membrane Oxygenation)

  • Usage: Extreme oxygen support; oxygenates blood outside the body.
  • Usage Context: Most invasive and supportive method.

Final Remarks

  • Learning Approach: Understand device capabilities and escalate support as needed.
  • Additional Resources: Subscriptions, quizzes, and educational materials available for further study.

Remember: Stay proactive in monitoring patient oxygenation and choose appropriate delivery methods to ensure efficient cellular respiration and patient stability.

Full transcript