Clinical Review ABC of oxygen

Oxygen therapy in chronic lung disease

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7162.871 (Published 26 September 1998) Cite this as: BMJ 1998;317:871
  1. P J Rees,
  2. F Dudley

    Short term oxygen therapy

    Oxygen in first aid

    Oxygen can be used in acute situations where there is hypoxia because of acute lung injury or reduced ventilation, when there is underlying chronic lung disease, or when it is important to maintain oxygen delivery to certain tissues. Maintaining oxygen delivery may help tissue survival when there is cardiac failure with pulmonary oedema, ischaemic tissue (such as after an infarction), or a cerebrovascular accident. Oxygen saturation should be monitored by pulse oximetry. If oxygen saturation is low additional inspired oxygen should be used to maintain saturation near 100%.

    Paramedics giving oxygen after a skiing accident

    Oxygen can be used empirically in acute situations if a patient is cyanosed or has a raised respiratory rate. Generally it is safe to use a high inspired oxygen concentration as long as there is no suggestion that the patient has chronic obstructive pulmonary disease. The main danger of acute oxygen is that carbon dioxide retention may occur in some patients with chronic obstructive pulmonary disease. If this is suspected the oxygen should be given by a high flow 24% or 28% mask until arterial blood gases can be measured. Oxygen increases the fire hazard at the scene of an accident.

    Small oxygen cylinders

    In emergency situations lack of availability of oxygen and an appropriate delivery system may prevent early treatment. Ambulances carry oxygen and paramedical staff are trained to use the equipment in acute situations. Some general practitioners also carry small cylinders that can deliver 2 l/min for two hours, which avoids the need to wait for an ambulance.

    Occasional oxygen in chronic lung disease

    Breathlessness in chronic lung conditions or in carcinoma of the bronchus may be intermittent. It is likely to increase on exertion, and simple everyday tasks such as washing, dressing, or eating may cause problems. Some patients feel that a short period on oxygen before or …

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