What is oxygen therapy?
The term oxygen therapy is usually used to describe long-term oxygen therapy (LTOT). It is used to treat severe, chronic oxygen deficiency (hypoxemia) by providing oxygen continuously or daily for several hours (more than 15 hours). In the long term, oxygen therapy improves the quality of life of patients with severe lung diseases or cardiac insufficiency. In severe cases, it may even be vital.
Short-term oxygen therapy can ensure the survival of patients after accidents or in cases of carbon monoxide poisoning.
A distinction must be made between classic oxygen therapy (long-term or short-term) and oxygen multistep therapy. This is a procedure from the field of alternative medicine, the effectiveness of which has never been proven so far and which is very controversial and therefore not discussed in this article.
Hyperbaric oxygen therapy
Another type of medical oxygen application is hyperbaric oxygen therapy, for example for tinnitus. You can read more about this in the article Hyperbaric oxygen therapy.
Oxygen therapy is used for diseases in which an adequate supply of oxygen cannot be ensured in any other way. In these diseases, the oxygen uptake in the red blood cells is not sufficient to supply the body’s organs adequately.
Such chronic oxygen deficiency is called chronic hypoxemic respiratory insufficiency. It is defined as multiple drops in blood oxygen pressure below 55 mmHg within three weeks under resting conditions and at normal atmospheric oxygen concentration, as determined by blood gas analysis. In patients with COPD and concomitant secondary polyglobulia (increase in the number of red blood cells) and/or a “pulmonary heart” (cor pulmonale), oxygen therapy is already indicated when the oxygen pressure in the blood falls below 60 mmHg.
The most common diseases with hypoxemia are:
- Chronic Obstructive Pulmonary Disease (COPD)
- Pulmonary emphysema
- Pulmonary scaffold diseases such as sarcoidosis
- Cystic fibrosis (cystic fibrosis)
- Pulmonary hypertension (pulmonary hypertension)
- severe chronic heart failure (congestive heart failure)
What do you do during oxygen therapy?
A detailed diagnosis of the time, causes and severity of the oxygen deficiency is the prerequisite for prescribing oxygen therapy. Then the oxygen pressure and oxygen saturation in the patient’s blood are determined by means of a blood gas analysis. These measurements can be used to determine the amount of oxygen needed for each individual.
In most cases, the oxygen is applied via a so-called nasal cannula, nasal mask or nasal probe. Very rarely, a special catheter is used, which is inserted into the lungs through an incision in the trachea below the larynx.
Often, electrically operated stationary systems – so-called oxygen concentrators – are used for oxygen therapy, which can also be applied at night while sleeping. In other cases, mobile pressure cylinders are used, which also allow patients to move around during oxygen therapy. For sufficiently mobile patients, a liquid oxygen system with a portable oxygen tank has proven effective. The tank is refilled or replaced approximately every two weeks.
Side effects of oxygen therapy performed as prescribed are very rare, but can occur even when used correctly:
- The inflowing oxygen can dry out the nasal mucosa. A humidifier as well as caring ointments can counteract this.
- The oxygen therapy devices are a potential source of infection for bacteria and fungi.
- If the oxygen concentration in the blood exceeds normal levels, this can inhibit respiratory drive and increase carbon dioxide levels in the blood. This triggers drowsiness and can even lead to life-threatening so-called CO2 narcosis.
- Pure oxygen escaping from the devices can easily ignite.
What do I have to pay attention to during oxygen therapy?
Consistent and long-term oxygen therapy in the flow rate determined by the physician is important. The duration of application should not be less than 15 hours in the case of chronic hypoxemia, since the positive effects on the clinical picture continue to improve with the duration of therapy.
Never discontinue the medically prescribed oxygen therapy on your own authority.
Regular inspection and hygiene of the equipment and oxygen probes used will ensure complication-free use.
If your condition worsens despite oxygen therapy, you should not hesitate to contact your doctor.
