For therapy with low to moderate concentrations of oxygen, the nasal cannula is usually the delivery device of choice. For acute exacerbations of chronic obstructive pulmonary disease with elevated arterial carbon dioxide tension, it is better to start with a fraction of inspired oxygen (FIO2) of 0.24 to 0.28, using an air-entrainment mask. FIO2 can then be rapidly titrated to achieve an oxygen saturation (measured by pulse oximetry) of 88% to 90%. Air-entrainment nebulizers and aerosol face masks can be used to administer an FIO2 of 0.28 to 0.40 to critically ill patients. For FIO2 of 0.50 and higher, consider the new class of high-flow, high-FIO2 nebulizers. Oxygen masks are generally reserved for short-term use to deliver a moderate to high FIO2. Arterial blood gas analysis remains the benchmark method of assessing oxygenation, but pulse oximetry can improve the monitoring of critically ill patients. For bronchial hygiene, no one method is superior. In acute care, chest physiotherapy and postural drainage are generally considered first.
|Original language||English (US)|
|Number of pages||9|
|Journal||Journal of Critical Illness|
|State||Published - Jan 1 2000|
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine