Four common complications of oxygen inhalation procedures

I. Invalid O₂ inhalation

1、Reasons for occurrence

     (1) Incorrect flow rate: If the flow rate of oxygen is too low, the individual may not receive enough oxygen to meet their needs.

     (2)Improper mask fit: An ill-fitting mask can cause oxygen to leak out, reducing its effectiveness.
     (3)Kinking or occlusion of tubing: The tubing used to deliver oxygen to the individual can become kinked or obstructed, reducing or cutting off the flow of oxygen.

     (4)Equipment malfunction: The oxygen delivery device or tank may malfunction, leading to reduced or no oxygen flow.

     (5)Patient noncompliance: The individual may not use the oxygen therapy as prescribed, leading to reduced effectiveness.

2.  Clinical manifestations

• Shortness of breath: If the flow of oxygen is reduced or cut off, the individual may experience difficulty breathing.

• Confusion or altered mental state: A lack of oxygen can lead to confusion, disorientation, or other changes in mental state.

• Rapid heart rate or palpitations: A reduced supply of oxygen to the body can cause an increase in heart rate or palpitations.

• Chest pain or discomfort: The individual may experience chest pain or discomfort if they are not receiving enough oxygen.

• Cyanosis: A bluish tint to the skin or mucous membranes may indicate a lack of oxygen in the blood.

3、Prevention and treatment

(1) Check carefully whether the oxygen inhalation device is intact before using oxygen to ensure that the pressure of the oxygen source is normal and the oxygen inhalation tube is tightly connected without air leakage. Secure the oxygen inhalation tube to the patient to avoid dislodgement and displacement and keep it open.

(2) Adjust the oxygen flow rate according to medical advice or the patient's condition and observe the effect of oxygen intake during the process.

(3) Remove respiratory secretions in a timely manner to keep the airway clear and avoid crusting of secretions to block the oxygen tube.

(4) Once ineffective oxygen inhalation is found, immediately identify the cause and take corresponding treatment measures to restore effective oxygen supply as soon as possible.

2、O₂ inhalation airway mucous membrane dryness

1、Reasons for occurrence

(1) Dryness in the hospital room, insufficient wetting solution in the oxygen wetting bottle, the inhaled oxygen cannot be fully wetted.

(2) Hyperventilation or excessive oxygen inhalation flow, oxygen concentration greater than 60%.

(3) Long-term oxygen inhalation.

2. Clinical manifestations

Symptoms of respiratory irritation appear: irritating dry cough, sticky sputum that is not easily coughed up, and dry discomfort in the nasal mucosa. Some patients have rhinorrhoea or blood in the sputum.

3. Prevention and treatment

(1) Maintain suitable temperature and humidity in the room and replenish the sterilized injection water in the wetting bottle in time to ensure that the inhaled oxygen is fully wetted.

(2) Adjust oxygen flow according to the condition. O₂ inhalation concentration is generally controlled at 45% or less (oxygen flow is appropriately controlled at 6L/min or less).

(3) Patients who are hyperventilating should be more hydrated, and patients who are breathing with their mouths open can have their mouths covered with wet gauze and changed regularly.

(4) For those with dry airway mucosa, ultrasonic nebulised inhalation can be given.

3、O₂ inhalation oxygen poisoning

Oxygen toxicity, also known as oxygen poisoning, can occur when an individual is exposed to high concentrations of oxygen for an extended period of time. This can cause damage to the lungs, eyes, central nervous system, and other organs.

In the lungs, oxygen toxicity can cause symptoms such as coughing, wheezing, and shortness of breath, as well as a condition called oxygen-induced lung injury (OILI). In the eyes, it can lead to a condition called toxic retinopathy, which can cause vision loss. In the central nervous system, oxygen toxicity can cause seizures and other neurological symptoms.

To minimize the risk of oxygen toxicity, it is important to carefully monitor the flow rate and concentration of oxygen being delivered, and to adjust it as needed based on the individual's needs and tolerance. If a person experiences symptoms of oxygen toxicity, the flow of oxygen should be reduced or stopped immediately to prevent further injury.

4、O₂ inhalation lung tissue damage

Prolonged exposure to high concentrations of oxygen can cause damage to the lung tissue, a condition known as oxygen toxicity. The most common form of oxygen toxicity in the lungs is known as oxygen-induced lung injury (OILI), which can cause symptoms such as coughing, wheezing, and shortness of breath.

The exact mechanisms of OILI are not completely understood, but it is thought to be caused by the formation of reactive oxygen species (ROS) in the lung tissue. These ROS can damage the cells and tissues of the lung, leading to inflammation and injury. In severe cases, OILI can progress to acute respiratory distress syndrome (ARDS), which can be life-threatening.

To minimize the risk of OILI, it is important to carefully monitor the flow rate and concentration of oxygen being delivered, and to adjust it as needed based on the individual's needs and tolerance.