Principles of oxygen therapy

Although oxygen therapy can be lifesaving, there is potential for harm. Potential harms include hypercapnia, which can be fatal, and adverse consequences related to hyperoxaemia. Oxygen therapy is generally not indicated unless the patient is hypoxaemic; see Indications for acute oxygen therapy.

Note: Oxygen therapy may lead to potentially fatal hypercapnia.

To ensure safe delivery, prescribe oxygen on a medication chart or an oxygen prescription form, specifying the delivery method, flow rate and patient-specific target oxygen saturation range.

Unlike ventilation systems, most oxygenation systems do not deliver a precise dose of oxygen at a particular flow rate, with the exception of the Venturi mask system and high-flow nasal cannula oxygen therapy1

Monitor the patient to ensure the target oxygen saturation is achieved and to detect adverse effects such as hypercapnia or hyperoxaemia; adjust the oxygen prescription if needed. See Monitoring acute oxygen therapy for more information.

Note: Prioritise management of the cause of hypoxaemia.

Investigate to determine the cause of hypoxaemia, and treat the cause. Oxygen only treats the hypoxaemia, but does not treat the underlying pathology; any need for increased oxygen should prompt thorough investigation for new or worsening pathology.

1 In high-flow nasal cannula oxygen therapy, fraction of inspired oxygen (FiO2) can be altered independently of the overall flow rate.Return