ABSTRACT
CLASSIFICATION Delivery Devices ■ Oxygen delivery devices are described in Table 1. ■ Oxygen flow and expected fraction of inspired oxygen (FIO2)
for different delivery devices are listed in Table 2.
Indications ■ Indications for low-flow and high-flow devices are listed in
Table 3. ■ Acute myocardial infarction and congestive heart failure
▲ For hypoxemia due to left ventricular failure, pulmonary edema, ventilation-perfusion mismatch
▲ Does not increase oxygen delivery if patient is not hypoxemic ▲ May increase systemic vascular resistance and decrease
cardiac output slightly. ▲ Can be omitted if PaO2 is normal ▲ No effect on complications or survival
■ Acute cor pulmonale ▲ Rapid and dramatic improvement of pulmonary hemody-
namics ▲ Decreases right ventricular afterload with pulmonary
infarction, infection, COPD ■ Chronic cor pulmonale
▲ Criteria for chronic oxygen therapy • PaO2 <55 mm Hg or SaO2 ≤88% • Or in the presence of cor pulmonale, heart failure, or
erythrocytosis (hematocrit >55%), PaO2 56-59 mm Hg or SaO2 ≤89%
• Or in the presence of lung disease or other clinical needs, PaO2 ≤60 mm Hg or SaO2 ≤90%
▲ Oxygen therapy should be prescribed for daytime and nighttime (and appropriately titrated) if these criteria are met during the day
▲ Oxygen therapy should be prescribed for exercise or sleep if these criteria are met during that activity
▲ Order sufficient oxygen to achieve PaO2 >60 mm Hg. ▲ Note: Oxygen therapy is the only treatment that improves
survival in COPD. ▲ Air travel
• Patients who require oxygen therapy at sea level will require it when traveling by airplane.
