Oxygen therapy

Standard Administration Options

Device L/min % Oxygen Comments
Nasal Cannula124%
Venturi mask24-50%Increasing flow will not alter FiO2
Oxygen tent10-1521-50%Used mainly on children with croup or pneumonia
Simple mask5-1535-55%Never used at flows less than 5 L/min to prevent rebreathing of CO2
Trach mask10-1535-60%Adequate flow shown by mist flowing out the exhalation port at all times
Partial rebreathing mask8-1535-60%Flow rate must be sufficient to keep bag 1/3 to 1/2 inflated at all times
Aerosol mask8-1521-99%
Non-rebreathing mask8-15 (or max)60-99%Flow rate must be sufficient to keep bag 1/3 to 1/2 inflated at all times

High-flow Nasal Cannula

  • Different Setup to low-flow O2 therapy
  • Good for hypoxemic respiratory failure
  • Every 10L/min is similar to 1mmHg PEEP
  • Set flow and FiO2%
  • Adults
    • Flow - start with 0.5 L/kg/min (Max 60L)
    • FiO2 - start with 100% and taper down from there
  • Pediatrics
    • FiO2 - Start 40% and titrate up
    • Flow - based on weight (table below) [1].
Weight (kg)<=1213-1516-3031-50>50
Starting flow rate2 l/min/kg25-30 l/min35 l/min40 l/min50 l/min

Hyperbaric Oxygen (HBO)

  • Two methods of administration[2]
    1. Small, single-occupant chamber filled with 100% oxygen and pressurized to desired level
    2. Large, multi-occupant chamber filled with room air and pressurized to desired level - occupants breathe supplemental oxygen at ambient pressure via mask
  • Rationale for use[2]
    • At normal pressures (even with supplemental oxygen administration), very little oxygen is dissolved in plasma
    • When oxygen provided at 3 ATA, there is enough oxygen dissolved in plasma to oxygenate all body tissues without resorting to hemoglobin-bound oxygen

See Also


  1. Richards-Belle A, Davis P, Drikite L, et al FIRST-line support for assistance in breathing in children (FIRST-ABC): a master protocol of two randomised trials to evaluate the non-inferiority of high-flow nasal cannula (HFNC) versus continuous positive airway pressure (CPAP) for non-invasive respiratory support in paediatric critical care BMJ Open 2020;10:e038002. doi: 10.1136/bmjopen-2020-038002 PDF: https://bmjopen.bmj.com/content/bmjopen/10/8/e038002.full.pdf
  2. Bitterman H. Bench-to-bedside review: Oxygen as a drug. Critical Care. 2009;13(1):205. doi:10.1186/cc7151.
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