OXYGEN THERAPY PROFESSOR CONOR BURKE

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Presentation transcript:

OXYGEN THERAPY PROFESSOR CONOR BURKE MD, FRCP(i), FRCP (LOND), FCCP, FFSEM CONSULTANT RESPIRATORY PHYSICIAN CONNOLLY HOSPITAL MATER UNIVERSITY HOSPITAL BONS SECOURS HOSPITAL UNIVERSITY COLLEGE DUBLIN

LIFE TISSUE OXYGEN DELIVERY TOD = CaO2 x CO

BLOOD OXYGEN CONTENT DISSOLVED O2 (<1%) + HAEMOGLOBIN BOUND O2 (>99%)

EVOLUTION BODY “DEFENDS” PaO2 OF 8.0 kPA INCREASED VENTILATION HYPOPXIC PULMONARY VASOCONSTRUCTION POLYCYTHAEMIA

DOMICILIARY OXYGEN THERAPEUTIC (COPD) PALLIATIVE

DOMICILIARY OXYGEN ASSESSMENT (COPD) ABG (NOT SAT) 30 MINUTES ON ROOM AIR 8 WEEKS POST EXACERBATON ABG TWICE 3 WEEKS APART

THERAPEUTIC DOMICILIARY OXYGEN COPD ONLY PaO2 < 7.3 kPa PaO2 < 8 kPa + PULMONARY HYPERTENSION ODEMA POLYCYTHAEMIA (Ht > 55%)

TITRATION START AT 1L/M AIM FOR PaO2 > 8.0 kPa If PaCO2 INCREASES ? BIPAP NOCTURNAL HYPOXIA EXERCISE HYPOXIA

DURATION (THERAPEUTIC) MRC TRIAL NOT TRIAL AT LEAST 15 HOURS DAILY

AMBULATORY O2 SAO2 < 90% ON 6 MWT CLINICAL IMPROVEMENT

OXYGEN CONCENTRATORS DELIVER UP TO 5 (9) L/M NASAL PRONGS (CONSERVERS) VENTURI MASK TRANSPORTABLE

CYLINDERS BACK-UP AMBULATORY

SHORT BURST O2 CLUSTER HEADACHE 15 L/M (CYLINDER) FOR 30 MINUTES

AIR TRAVEL PaA2 > 9.3 kPa SAFE HYPOXIC CHALLENGE FEV1 < 30% BULLOUS DISEASE RECENT EXACERBATION (6 WEEKS) RECENT PNEUMNOTHORAX

SAFETY CIGARETTES VAPING CHARGING UNDER MATERIAL VASELINE