Showing posts with label oxygen levels. Show all posts
Showing posts with label oxygen levels. Show all posts

Monday, October 12, 2015

Does your patient need and qualify for oxygen therapy

The following was originally published on April 15, 2015 at healthcentral.com/copd.

Do you need oxygen therapy? 

Sometimes people with COPD need to inhale more oxygen than what is provided in the air. The way this is accomplished is by using oxygen therapy. So what is oxygen therapy, and do you need it?

Oxygen in room air contains 21 percent oxygen. Usually this is plenty of oxygen. However, certain disease conditions, such as what may occur as COPD progresses, or during COPD flare-ups, may create areas inside your lungs where oxygen is inhaled, but cannot get to your bloodstream. When enough of these areas exist, your blood oxygen levels may decline.

To learn more about oxygen and oxygen levels, please read my post “Understanding Oxygen and Oxygen Levels with COPD.”

What is oxygen therapy? It involves inhaling supplemental oxygen, or oxygen percentages that are greater than 21 percent. It allows you to inhale 22-100 percent oxygen, depending on the device used.

Nasal Cannula. This involves inserting prongs into your nose. A low flow allows you to inhale anywhere from 22-44 percent oxygen. This is all that is needed for most people with COPD. It is very comfortable and tolerable.

Masks. A variety of masks can used to provide up to 100 percent oxygen. These are not used very often, but are available if needed.

To learn more about oxygen devices read my post “Oxygen Therapy Made Easy.”

There are three ways of getting oxygen therapy into your home.
  1. Compressed Oxygen Gas Cylinders. These are tanks with regulators and flowmeters. Some are larger and stay at your home, and some are smaller for travel. 
  2. Liquid Oxygen. They hold more oxygen and are smaller and more lightweight, making them ideal for people who are constantly on the move.
  3. Oxygen Concentrators. They are electronic devices about the size of end tables that make oxygen by concentrating oxygen from room air. These are nice because, so long as you have electricity, you always have a source of supplemental oxygen. 
These are described in more detail in the post “The Three Types of Oxygen Therapy for COPD.”

Most people who require oxygen therapy will use oxygen concentrators at home, and have a variety of tanks as a backup in case of a power outage, and also for travel.

Do you need oxygen therapy? If your oxygen levels are chronically low, this puts strain on your body that can shorten your lifespan. That said, supplemental oxygen is the only drug proven to prolong life.

Common signs and symptoms of low blood oxygen levels (hypoxemia) are.
  • Bluish tinge to your fingertips, toes and lips
  • Rapid heartbeat
  • Sweating
  • Confusion
  • Feeling winded, especially with exertion
If you, or a loved one, observes these signs, you should seek medical attention immediately. Your doctor may at first treat your COPD flare-up. Once you are deemed to be in a “chronic stable state,” your doctor may qualify you for oxygen therapy.

Do you qualify for home oxygen therapy?
The qualifications for home oxygen are set by the Centers for Medicare and Medicaid Services (CMS), and they prefer numbers over subjective signs and symptoms. So qualifying is determined by the following test results:
The basic premise goes like this: you qualify for oxygen therapy if your:
  • PO2 is 55 or less or your SpO2 is 88 percent or less at rest while breathing room air.
  • PO2 is 55 or less or your SpO2 is 88 percent or less while you are sleeping; or, if your PO2 drops 10 percent or more, or your SpO2 drops 5 percent or more, while you are sleeping, and you are also displaying symptoms of hypoxemia. 
  • PO2 is 55 or less or your SpO2 is 88 percent or less while you are exercising.
How much oxygen do you need? The goal of oxygen therhapy is to provide you with the least amount of supplemental oxygen to maintain an SpO2 at 90 percent or greater. Usually, a low flow of 2-3 LPM using a nasal cannula works great. And, considering the benefits, most people tolerate it very well.

Further Reading:

Monday, October 5, 2015

What patients need to know about oxygen levels

The following was originally published on April 3, 2015

Understanding Oxygen and Oxygen Levels

Oxygen is essential to a normal functioning body. The progression of COPD, and COPD flare-ups, may cause your oxygen levels to become low. So what does this mean to you? Here is all you need to know about oxygen and oxygen levels.

What is oxygen?

It’s an element with the symbol O. It makes up about 21 percent of air. When you inhale, it travels through your lungs to your bloodstream, and then travels to tissues, such as heart tissue. A cell on this tissue will use it to make energy needed for it to perform its work. Lack of oxygen may cause tissue damage, such as heart damage.

How are oxygen levels monitored?

There are two tests:
  1. Arterial Blood Gas (ABG). This involves an blood draw from your wrist or arm. Thankfully, this test doesn’t need to be done too often thanks to another, simpler test called...
  2. Pulse Oximetry. A probe is placed over your finger or earlobe. Since this is an easy test, it is often considered the fifth vital sign, and may be checked frequently.
What are oxygen levels?

They measure how efficient your lungs are at inhaling oxygen and transporting it into your bloodstream. The three most important are:
  1. SaO2. It's a percentage that shows how saturated your arterial blood is with oxygen. It's obtained from an ABG, so it's very accurate. Normal is 95-98%, although 90% or better is usually considered acceptable.
  2. PaO2. It's the partial pressure of arterial oxygen. It's obtained from an ABG, and is an accurate measure of oxygen in arterial blood. A normal range is 80-100, although 60 or better is usually considered acceptable. It's the same as SaO2, although it's estimated by pulse oximetry. A normal value is 95-98%, although 90% or better is usually considered acceptable. 
What are low oxygen levels?
  1. Hypoxemia. This is the term used when your PaO2 is less than 60 or your SaO2 and SpO2 are less than 90 percent. It means your blood oxygen level is low. Hypoxemia may lead to hypoxia.
  2. Hypoxia. This means your tissues aren’t getting enough oxygen. 
456-789 Rule. This explains why your doctor doesn’t always need an ABG to check your oxygen levels. Generally speaking, your SpO2 matches up with your PO2 as follows:
  • 90 percent SpO2 = 60 PO2 (this is your normal range, and usually no oxygen therapy is needed)
  • 80 percent SpO2 = 50 PO2 (this is your hypoxemic range, meaning oxygen therapy is needed)
  • 70 percent SpO2 = 40 PO2 (this is severe hypoxemia, immediate treatment is needed to prevent tissue damage and death)
What causes low oxygen levels? The natural progression of COPD may cause areas in your lungs where oxygen gets in but is blocked from getting to the bloodstream. This may be due to loss of lung tissue (emphysema) or airway obstruction (bronchitis). COPD flare-ups may exacerbate this problem.

How does your body respond to hypoxia? When your brain senses hypoxia, your blood vessels constrict and your heart pumps harder and faster, sending blood in search of more oxygen. Your body shunts freshly oxygenated blood away from fingertips, toes and lips in favor of vital organs, such as your heart.

Symptoms
. When your oxygen levels are low, your body will let you know. Common symptoms include a bluish tinge to your fingertips, toes and lips (cyanosis), rapid heartbeat, sweating, confusion, and feeling short of breath or winded.

Long-Term Consequences. Hypoxemia with COPD may become chronic, meaning it’s always there and your body gets used to it. This may mean that the blood vessels in your lungs are chronically constricted, forcing your heart to work extra hard to pump blood through your lungs. Over time, this causes your heart to become enlarged (hypertrophy). This makes it a weaker pump, and may lead to heart failure.

Treatment
. Your doctor will usually recommend the lowest amount of oxygen needed to keep your PaO2 at safe levels, which is usually 60 or better. So this means an SpO2 of about 90 percent is the goal, although sometimes 88 percent is acceptable. Medicine like corticosteroids and albuterol may help reduce inflammation and open airways.

Be Compliant. Oxygen is essential to life. Making sure your oxygen levels stay at safe levels is essential to living well with COPD. Work with your doctor, follow your COPD Action Plan, pay attention to what your body is telling you, and use your oxygen therapy as prescribed (if prescribed).

Further reading: