Oxygen therapy pneumonia

High concentration oxygen therapy is reserved for a state of low PaOj in association with a normal or low PaCO (type I respiratory failure), as in pulmonary embolism, pneumonia, pulmonary oedema, myocardial infarction, and young patients with acute severe asthma. Concentrations of up to 100% may be used for short periods, since there is little risk of inducing hypoventilation and CO retention. 

Acute inhalation or aspiration of ingested aliphatic or aromatic petroleum hydrocarbons of low viscosity can lead to pulmonary irritation and hydrocarbon pneumonia, an acute hemorrhagic necrotizing disease. To counteract secondary bacterial infections and pulmonary edema, antibiotics and oxygen therapy are often applied when indicated by symptoms in particular patients (Klaassen... 

Bach JR, Rajaraman R, Ballanger F, et al. Neuromuscular ventilatory insufficiency effect of home mechanical ventilator use v oxygen therapy on pneumonia and hospitalization rates. Am J Phys Med Rehabil 1998 77 8-19. 

The patient was admitted to the hospital with a presumptive diagnosis of health care-associated pneumonia (based on the recent hospitalization). He received intravenous hydration with normal saline, 5 L oxygen via face mask, an insulin infusion to control his glucose, and empirical antimicrobial therapy with piperacillin-tazobactam 2.25 g intravenously every 6 hours and vancomycin 1 g intravenously every 24 hours. All other medications are continued with the exception of the diabetes medications. 

The patient s vital signs provide the most sensitive indicator of response to therapy and normalisation of heart rate, respiratory rate, oxygenation, blood pressure and temperature should be confirmed. Laboratory markers of infection such as CRP and WCC should be monitored to ensure normalisation. Failure to improve may indicate an incorrect diagnosis, a resistant pathogen, poor absorption of antibiotic, immunocompromise or local or distant complications of community-acquired pneumonia such as lung abscess. 

Oxygen, Liquefied Safety goggles or faces shield, insulated gloves, long sleeves, trousers worn outside boots or over high-top shoes to shed spilled liquid. In all but the most severe cases (pneumonia) recovery is rapid after reduction of oxygen pressure. Supportive treatment should include immediate sedation, anticonvulsive therapy if needed and rest. Treat frostbite. Soak in lukewarm water. Treat frostbite burns. 

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