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8/13/2019 Devices in Oxygen Therapy
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DEVICES IN OXYGEN
THERAPY
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OXYHAEMOGLOBIN DISSCOCIATION CURVE
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FACTORS INFLUENCING OXY-HB
DISSOCIATION CURVE
Shift to right ( P50 ↑) :favours Hb unloading of O2 , and thusoxygen delivery to the tissue.
1. Temperature ↑
2. pH ↓
3. 2,3 DPG ↑
4. ATP ↑
5. MCHC ↑
6. Cortisol
7. Aldosteron
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Cont’d…………………………………………. Shift to left ( P50 ↓ )
increase the affinity of Hb for O2 with reducedtissue oxygenation.
1. Temperature ↓
2. pH ↑
3. 2,3 DPG ↓
4. ATP ↓
5. Foetal Hb
6. Carboxyhaemoglobin
7. Methaemoglobin
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FRACTIONAL INSPIRED OXYGEN
CONCENTRATION (FiO2)
Depend on technique
Nasal cannule
Simple face mask
Reservoir face mask
Venturi mask
Head box
Oxygen tent and incubator
Ventilator
Depend on peak inspiratory flow
Depend on gas flow
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THE BASIC REQUIREMENTS OF
DEVICES FOR USE IN OXYGEN
THERAPY
1. Control of fractional inspiredoxygen concentration (FiO2).
2. Prevention of excessive CO2
accumulation.
3. Minimal resistance to breathing.
4. Efficient and economical use ofoxygen.
5. Acceptance by patient.
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Flow
(L/men)
Desired
FiO2
Measured FiO2
Gibson etal
Schachteret al
1 0.24 0.22 0.23
2 0.280.21 – 0.22
0.24
3 0.320.22 – 0.24
0.25
4 0.36 0.26
5 0.400.24 – 0.25
10 0.520.30 – 0.46
15 0.560.35 –
0.61
NASAL CANNULE
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Flow (L/men) Desired FiO2
5 -6 0.4
6 – 7 0.5
7 – 8 0.6
SIMPLE FACE MASK
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Flow (L/men) Desired FiO2
6 0.6
7 0.7
8 0.8
9 -10 0.9 – 0.99
RESERVOIR FACE MASK
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VENTURI MASK
Gas flow(L/men)
FiO2
4 – 80.24 / 0.28 /0.35 / 0.40 /0.50 / 0.60
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FIXED VENTURI MASK
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HUMIDIFICATION
PHYSIOLOGY Inspired gas is warmed nad humidified in the
nasopharynx and reaches the upper trachea
with a RH of about 90% and temp.32 –
360
C. In alveoli gas is full saturated at 37 0C ( AH is
43 g/m3).
Cilliary actifitity ceases at temp.> 41 0C and
slow down when RH < 75% at 370
C (AH 32g/m3)
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HUMIDIFIER
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TEMPERATURE AND SATURATED
VAPOUR PRESSURE RELATIONSHIP
Temperatur
(0 C)
Saturatedvapour
pressure
Absolute hum(g / m3)
0 4.6 mmHg 4.8
10 9.2 9.3
20 17.5 17.1
30 31.3 30.4
34 39.9 37.537 47.1 43.4
40 55.3 51.7
46 78.0 68.7
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IDEAL HUMIDIFICATION
1. The inspired gas is delivered into the trachea at
320C-360C and with water content of 33-43g/m3.
2. The device is simple to use and to service.
3. Humidification can be provide for air, oxygen orany mixture of inspired gas.
4. There are safety mechanisms (with alarms)against overheating, overhydration, andelectrocution.
5. There is patient acceptance.The resistance,
compliance, and dead space characteristics ofthe whole bretahing system are not adverselyaffected.
6. The sterility of the inspiredgas is notcompromised.
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THANK YOU
