Oxygen therapy with

General supportive measures are likely to be effective in therapy of intoxication. Artificial ventilation could be lifesaving in the case of neurotoxins such as the botulinum toxins and saxitoxin. Oxygen therapy, with or without artificial ventilation, may be beneficial for intoxication with toxins such as ricin that directly damage the alveolar-capillary membrane of the lung. Vasoactive drugs and volume expanders could be used to treat the shocklike state that accompanies some intoxications (eg, with staphylococcal enterotoxin B). These measures could be used in conjunction with more specific therapies. 

Oxygen therapy with pulse oximetry Every hour check blood pressure, heart rate, respiratory rate, intake, and output continuous ECG 4 Cardioversion (atrial fibrillation) Hemodynamic monitoring (cardiac output) Daily weights... 

A more common cause for "altered" P02 values is the age of the individual. Normal P02 values decrease with age in addition, surgical procedures cause a temporary (post-operative period) decrease of the individual s P02 values. Various regression formulas have been presented describing the decrease of P02 with increasing age under normal conditions (6-12)> after surgery (10, 13-17), and with oxygen therapy (10, 16). 

Initiate therapy with a short-acting p2-agonist and 2 to 6 L/minute of oxygen if needed. 

Long-term administration of oxygen (greater than 15 hours per day) to patients with chronic respiratory failure has been shown to reduce mortality and improve quality of life.1,2 Oxygen therapy should be initiated in stable patients with very severe COPD (GOLD stage IV) who are optimized on... 

Cluster headache responds to many of the same treatment modalities used in acute migraine however, initial prophylactic therapy is required to limit the frequency of recurrent headaches within a periodic series. A novel therapy specific to cluster headaches is the administration of high-flow-rate oxygen 100% at 5 to 10 L/minute by non-rebreather facemask for approximately 15 minutes.42 If pain is not aborted, then retreatment is indicated. No side effects are seen with short-term oxygen use. If oxygen therapy is not wholly effective, then pharmaceuticals... 

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. 

Continue oxygen therapy until patient is asymptomatic and blood carbon monoxide levels are below 10%. For individuals with blood carbon monoxide levels above 40%, consider transfer to a hyperbaric facility. 

Patients with acute chest syndrome should receive incentive spirometry appropriate fluid therapy broad-spectrum antibiotics including a mac-rolide or quinolone and, for hypoxia or acute distress, oxygen therapy. Steroids and nitric oxide are being evaluated. 

In a patient with chronic respiratory acidosis (e.g., chronic obstructive pulmonary disease), treatment is essentially similar to that for acute respiratory acidosis with a few important exceptions. Oxygen therapy should be initiated carefully and only if the Pao2 is less than 50 mm Hg because the drive to breathe depends on hypoxemia rather than hypercarbia. 

Oxygen therapy should be considered for any patient with hypoxemia during an exacerbation. Caution must be used because many COPD... 

Vitamin E may be indicated in some rare forms of anemia such as macrocytic, megaloblastic anemia observed in children with severe malnutrition and the hemolytic anemia seen in premature infants on a diet rich in polyunsaturated fatty acids. Also anemia s in malabsorption syndromes have shown to be responsive to vitamin E treatment. Finally, hemolysis in patients with the acanthocytosis syndrome, a rare genetic disorder where there is a lack of plasma jS-lipoprotein and consequently no circulating alpha tocopherol, responds to vitamin E treatment. In neonates requiring oxygen therapy vitamin E has been used for its antioxidant properties to prevent the development retrolental fibroplasia. It should be noted that high dose vitamin E supplements are associated with an increased risk in allcause mortality. 

Carbon monoxide (CO) binds tightly to the Hb iron. It stabilizes the R form of Hb and, thus, prevents release of 02 to the tissues. CO toxicity is, in large part, a result of tissue hypoxia. CO poisoning is treated with 100 percent oxygen therapy, which facilitates the dissociation of CO from the Hb, allowing more 02 to be bound to Hb. 

Tracheobronchial aspirate fluid in mechanically ventilated preterm infants correlated positively with mean daily fractional inspired oxygen concentration and was very low in babies not requiring oxygen therapy (VI3). 

Nash G, Blennerhasset JB, Pontoppidan H. Pulmonary lesions associated with oxygen therapy and artificial ventilation. N Engl J Med 1967 276 368-374. 

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