Oxygen Therapy

Oxygen therapy provides extra oxygen to people whose bodies cannot get enough on their own. This treatment helps prevent serious complications from low oxygen levels and can greatly improve quality of life for those with breathing difficulties.

Table of contents

• What is Oxygen Therapy?
• Who Needs Oxygen Therapy?
• How Oxygen Therapy Works
• Understanding Oxygen Levels
• Signs of Low Oxygen
• Types of Oxygen Delivery Systems
• Delivery Methods
• Benefits of Oxygen Therapy
• Safety Considerations
• Living with Oxygen Therapy

What is Oxygen Therapy?

Oxygen therapy is a medical treatment that provides you with extra oxygen to breathe in. It is also called supplemental oxygen, which means it adds to the oxygen you naturally get from the air around you^[1].

When you breathe normally, your body takes in air that contains about 20% oxygen and 80% nitrogen. Your lungs filter oxygen from this air and send it through blood vessels to your organs, tissues, and cells. Every cell in your body needs oxygen to function properly^[1][3].

Oxygen therapy can take place in many different settings. You may receive it in a hospital, a care facility like a nursing home, or at your home. There are also portable oxygen systems that you can take with you wherever you go^[1].

Who Needs Oxygen Therapy?

You may need oxygen therapy if you have a condition that prevents your lungs from absorbing enough oxygen or stops your blood from carrying enough oxygen to your cells. People who need supplemental oxygen often have lung diseases or breathing disorders^[2][4].

Common conditions that may require oxygen therapy include:

• Asthma, bronchitis, or emphysema (a lung condition that causes shortness of breath)
• Chronic obstructive pulmonary disease (COPD), a group of lung diseases that block airflow and make breathing difficult
• COVID-19
• Cystic fibrosis, a genetic disorder that affects the lungs
• Heart failure
• Lung cancer or other cancers
• Pneumonia
• Pulmonary fibrosis, scarring of the lungs
• Sleep apnea

People who live in or visit high-altitude areas, such as mountain climbers, may also need supplemental oxygen. Oxygen levels in the air are lower at high altitudes, which can lead to altitude sickness^[1].

Some people need extra oxygen all the time, while others need it only occasionally or in certain situations, such as during sleep, rest, physical activity, or at high altitude^[5][7].

How Oxygen Therapy Works

Oxygen therapy gives your body the oxygen it is not getting when you breathe in air normally. You can think of it as a respiratory system aid^[1].

When you have lung problems, not enough oxygen reaches your cells to keep your body and organs working as they should. You develop low blood oxygen levels, a condition called hypoxemia. Over time, hypoxemia can lead to organ damage and organ failure. Without enough oxygen, your body cannot function properly, and lack of oxygen can be life-threatening^[1][3].

Supplemental oxygen therapy helps ensure that your cells receive adequate oxygen to support essential functions and prevent serious complications^[3].

Understanding Oxygen Levels

A healthy oxygen level, also called oxygen saturation, is 95% or higher. Healthcare providers typically prescribe oxygen therapy when oxygen levels drop below 88%^[1].

In most conditions, an oxygen saturation of 94–96% is adequate. For people at risk of carbon dioxide buildup, such as those with COPD, saturations of 88–92% are preferred. In cases of carbon monoxide poisoning or cardiac arrest, saturations should be as high as possible^[6].

Your doctor will test the amount of oxygen in your blood to determine whether you need oxygen therapy. There are several ways to measure oxygen levels:

• Pulse oximeter: This small device painlessly clips onto your finger, toe, or earlobe. Sensors in the device send light beams through your skin to measure oxygen levels in tiny blood vessels called capillaries. Many providers routinely perform this test at each appointment. You can also buy a pulse oximeter at drugstores to use at home^[1].
• Arterial blood gas test: This test uses a blood sample from an artery to measure oxygen and carbon dioxide levels in your blood. This test is the most accurate method for determining lung function^[1].
• Lung function tests: Tests like spirometry measure how well you inhale and exhale air. Some tests also measure your lungs’ ability to send oxygen into your cells^[1].

Signs of Low Oxygen

You cannot always tell when your oxygen levels are low. Some people with pulmonary fibrosis may not experience symptoms even when they are not getting enough oxygen into their bloodstream^[5][14].

However, many people who need supplemental oxygen experience shortness of breath or fatigue. When symptoms of low oxygen occur, you may experience^[1][5]:

• Shortness of breath
• Bluish tint to skin, lips, and nails
• Extreme fatigue
• Severe headaches
• Coughing or wheezing
• Fast pulse and heart rate
• Rapid heart rate with activity
• Confusion
• Irritability
• Ankle swelling

If you experience any of these symptoms, seek immediate medical attention^[4].

Types of Oxygen Delivery Systems

Oxygen comes in gas or liquid form. Oxygen systems may be large and stationary for home use, or small and portable^[1].

Types of oxygen therapy delivery systems include:

Compressed gas: A large metal cylinder stores 100% oxygen as a gas under pressure. The cylinder has a regulator to control the flow of oxygen. An oxygen-conserving device sends oxygen when you inhale and stops oxygen flow when you exhale. These tanks eventually run out of oxygen, and a gauge on the tank shows how much oxygen remains^[1].

Liquid oxygen: A liquid oxygen system stores oxygen in liquid form, which takes up less room than oxygen gas. Because of this, smaller and lighter containers can hold more oxygen. These systems are often used for people who need portable oxygen outside the home^[7][8].

Oxygen concentrators: Concentrators take oxygen from the air around you and remove other gases. Standard concentrators need to be plugged into a power outlet and are typically used in the home. There are also portable types that can be used outside the home. These devices do not need to be refilled like tanks do^[7][8].

Delivery Methods

To breathe the oxygen, most people use a nasal cannula. This is a thin, flexible plastic tube with two prongs that fit just inside your nose. It gives you the greatest freedom for moving around and talking^[7].

A face mask may be a good choice if you need a higher flow of oxygen. The mask fits over your nose and mouth. However, a face mask is less portable and gets in the way of talking and eating. You might use a face mask at night and a nasal cannula during the day^[7].

Your oxygen prescription will specify when to use your oxygen (during sleep, rest, activity, or at altitude), how much oxygen you need for each activity (number setting or liter flow), and what type of delivery system to use^[5].

Benefits of Oxygen Therapy

Oxygen therapy can make it easier for you to breathe and can reduce your heart’s workload. People who receive oxygen therapy often see improved energy levels and sleep, and better quality of life^[1][4][7].

For people with pulmonary fibrosis and other lung diseases, supplemental oxygen allows cells to get the oxygen they need when scarring or inflammation in the lungs makes it difficult for oxygen to cross into the bloodstream. This can help reduce breathlessness and allow you to stay active and continue doing the things you enjoy^[5][16].

Using oxygen therapy as prescribed by your healthcare provider helps you feel and sleep better and can prevent serious complications from low oxygen levels^[1].

Safety Considerations

In most cases, there are no risks from oxygen therapy as long as you follow your doctor’s instructions. However, oxygen is a fire hazard, so it is critical to follow safety rules^[7].

Fire safety:

• Do not smoke or vape, and do not let others smoke or vape while you are using oxygen
• Do not use oxygen near open flames, anything that may spark, or anything flammable
• Keep oxygen away from candles, fireplaces, gas stoves, or hot water heaters
• Do not use it near electric razors, hair dryers, heating pads, or anything that may spark
• Put up “no smoking” signs in your home
• Keep a working fire extinguisher in your home where it is easy to reach
• If a fire starts, turn off the oxygen right away and leave the house^[7][21][22]

Equipment safety:

• Do not leave cords or tubing running across an area where you or someone else may trip on it
• Keep oxygen containers upright and make sure they do not fall over and get damaged. Try securing tanks in a sturdy container or with a rope or chain
• Do not let oxygen containers get hot. Store them in a cool place where there is airflow. Do not leave them in a car trunk or a hot vehicle
• Avoid touching frost that can form on liquid oxygen devices, as frost can cause skin burns^[7][21]

Medical safety:

• Do not change your oxygen flow rate. Your doctor sets this at the correct level. Higher flow rates usually do not help and can increase the risk of harmful carbon dioxide buildup in the blood^[7][14]
• Oxygen is not addictive. Use it as prescribed by your healthcare provider^[5]
• Do not use alcohol or take drugs that relax you, because they will slow your breathing rate^[21]

Oxygen therapy can also dry out the nasal passages without proper humidification. You may experience a dry or bloody nose, tiredness, or morning headaches^[6][10].

Living with Oxygen Therapy

Integrating oxygen therapy into your daily life means making it comfortable and practical for you. Here are some tips for living with oxygen therapy:

Skin care and comfort: Using oxygen therapy may dry out your nose or lips. Use water-based lubricants on your lips or nostrils. Do not use oil-based products like petroleum jelly, as they may cause skin burns. Keep your nose and lips moist with aloe vera or a water-based lubricant^[18][21].

If you use a nasal cannula, the tubing may rub under your nostrils and around your ears, causing discomfort. To keep your skin from getting sore, tuck some gauze under the tubing. Use a water-based lotion on rubbed areas. You can also ask your oxygen provider for foam cushions to help with any discomfort from the tubes resting on your ears^[18][21].

Equipment maintenance: It is important to plan a schedule for when you will replace your tubing and cannulas. According to the American Lung Association, it is a good idea to replace your cannula every two to four weeks or anytime you get sick, and to replace the tubing every two months. Having extra tubing and cannulas close at hand can help with any mishaps or potential equipment issues when they arise^[16][18].

Keep track of how much oxygen is in the tank and reorder before it runs out. If a holiday is coming up or you expect bad weather, order in advance or make your regular order larger^[21].

Traveling with oxygen: Whether for long distances or a short weekend trip, traveling with oxygen requires planning. Talk to your doctor about whether you need to make any changes to your oxygen therapy during travel. You may need extra oxygen when you travel to high altitudes or travel by plane^[18][21].

When flying, contact your airline beforehand to obtain a list of approved devices and required documentation. Be sure to research airlines before booking your flight and compare the services and accommodations each airline provides. Arrive early for your flight in case any questions or concerns arise. Pack everything you may need, including inhalers, medications, and extra batteries or power cords in your carry-on luggage^[18].

Staying active: Using oxygen therapy does not have to limit your activities or travels. In fact, it can help open up the world for you by reducing breathlessness and allowing you to participate in activities you enjoy. Supplemental oxygen can help you stay active and continue doing things with family and friends^[16][18].