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    Terapi Oksigen

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    Yohana Septhiya
    Redhy Sindharta is an anesthesiologist at Palangkaraya University. His document discusses supplemental oxygen for patients with Acute Respiratory Failure. It notes that supplemental oxygen can substantially increase PaO2 levels and oxygenation in most ARF cases. A variety of oxygen delivery devices are available including nasal cannula, reservoir face masks, and low flow oxygen inhalation systems. The effectiveness of these devices depends on their ability to deliver sufficient oxygen at adequate flow rates matched to patient inspiratory flow. The document also cautions that unregulated, overzealous oxygen can produce toxic metabolites and potentially be lethal. It concludes with diagnostic criteria for acute lung injury and acute respiratory distress syndrome.

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    Terapi Oksigen

    Uploaded by

    Yohana Septhiya
    112 views12 pages
    Redhy Sindharta is an anesthesiologist at Palangkaraya University. His document discusses supplemental oxygen for patients with Acute Respiratory Failure. It notes that supplemental oxygen can substantially increase PaO2 levels and oxygenation in most ARF cases. A variety of oxygen delivery devices are available including nasal cannula, reservoir face masks, and low flow oxygen inhalation systems. The effectiveness of these devices depends on their ability to deliver sufficient oxygen at adequate flow rates matched to patient inspiratory flow. The document also cautions that unregulated, overzealous oxygen can produce toxic metabolites and potentially be lethal. It concludes with diagnostic criteria for acute lung injury and acute respiratory distress syndrome.

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    Redhy Sindharta is an anesthesiologist at Palangkaraya University. His document discusses supplemental oxygen for patients with Acute Respiratory Failure. It notes that supplemental oxygen can substantially increase PaO2 levels and oxygenation in most ARF cases. A variety of oxygen delivery devices are available including nasal cannula, reservoir face masks, and low flow oxygen inhalation systems. The effectiveness of these devices depends on their ability to deliver sufficient oxygen at adequate flow rates matched to patient inspiratory flow. The document also cautions that unregulated, overzealous oxygen can produce toxic metabolites and potentially be lethal. It concludes with diagnostic criteria for acute lung injury and acute respiratory distress syndrome.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    112 views12 pages

    Terapi Oksigen

    Uploaded by

    Yohana Septhiya
    Redhy Sindharta is an anesthesiologist at Palangkaraya University. His document discusses supplemental oxygen for patients with Acute Respiratory Failure. It notes that supplemental oxygen can substantially increase PaO2 levels and oxygenation in most ARF cases. A variety of oxygen delivery devices are available including nasal cannula, reservoir face masks, and low flow oxygen inhalation systems. The effectiveness of these devices depends on their ability to deliver sufficient oxygen at adequate flow rates matched to patient inspiratory flow. The document also cautions that unregulated, overzealous oxygen can produce toxic metabolites and potentially be lethal. It concludes with diagnostic criteria for acute lung injury and acute respiratory distress syndrome.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 12

    Redhy Sindharta

    Anesthesiologist

    Faculty of Medicine
    Palangkaraya University

    Sept 2018
     Most patient with Acute Respiratory Failure (ARF) 
    require suplemental Oxygen
     In most cases of ARF  PAO2 can be substantially
    increased by use of suplemental oxygen 
    increasing the gradient across the membrane and
    improving the PaO2
     Suplemental Oxygen can be provided by a variety of
    devices
     Important to document to interpret the result properly
     The effectiveness is determined by:

    Capacity of the device deliver sufficient oxygen


    at high enough flow rate
    with
    The patient inspiratory flow rate
    Nasal Cannula
    - Short Prongs of the nasal cannula are inserted into the nares
    - Oxgen 100% is delivered, but at a flow rate between 0,5 and 5 L/m.
    FiO2 depends on MV. Low-Flow, Low-Oxygen Device

    Advantages Disadvantages
    Comfortable and well tolerated Cannot be controlled precisely
    Easy to use Maximal FiO2 below 0,4-0,5
    Higher flow rates  drying and irritating
    nasal mucosa
    Reservoir Face Mask
    - When the mas properly applied  maximized but
    rarely exceed an FiO2 0f 0,6-0,9
    - A reservoir mask is frequently used for improving
    oxygenation in patients with severe hypoxemia until
    further evaluation and treatment are accomplished
    - High oxygen-flow device

    Advantages Disadvantages
    Greater ability to control Must create a tight seal
    Low Flow Oxygen Inhalation
    Systems
    The FiO2 delivered may be
    estimated as follow:
    1. Nasal Prongs (2-4 L/mnt):
    21% + 4% every litre per minute
    1. Standard Mask (6-8 L/mnt):
    FiO2 50-60%
    1. Reservoir Mask (Non Rebreather Mask):
    FiO2 80-85%
    The Dark Site of Oxygen

    Unregulated & overzealous

    Toxic Metabolites

     Potential powerful and lethal toxin

    -
    Diagnostic Criteria for ALI and ARDS
    1. Acute Onset
    2. Presence of a presdiposing condition
    3. Bilateral infiltrat on frontal chest x-ray
    4. PaO2/ FiO2 < 200 mmHg for ARDS, or < 300 mmHg
    for ALI
    5. Pulmonary artery oclussion presure ≤ 18 mmHg or
    no clinical evidence of left atrial hypertension.
    Literatures
    1. Society of Critical Care Medicine. Fundamental
    Critical Care Support. 4th ed. Mount Prospect, 2007.
    2.Marino, Paul L.. Th ICU Book. 3rd edition. Lipipincot
    Williams and Wilkins : Philadelphia, 2007.
    3. Ooi, Shirley and P.Manning. Emergency Medicine. Mc
    Graw Hill: Singapore, 2004.

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