Oxygen Therapy: Purpose, Factors | Complications of Endotracheal Intubation

Definition of Oxygen:

Oxygen is the odorless gas that is present in the air and necessary to maintain life. Oxygen may be given in a medical setting, either to reduce the volume of other gases in the blood or as a vehicle for delivering anesthetics in gas form.

Oxygen is a colorless and odorless gas which is essential for life. Normally a person will take the Oxygen required by the body, normal breath and taken up into the blood.

Ā Definition of Oxygen Therapy:

Oxygen therapy is a method by which oxygen is administered in low concentration through a cannula which is disposable plastic device with two protruding prongs for insertion into the nostrils or administering oxygen to the patient by means of a mask according to requirement of patient.

Oxygen Therapy
Fig: Oxygen Therapy

Purposes of Oxygen Therapy:

It includes-

  1. To relieve dyspnea.
  2. To improve tissue oxygenation.
  3. Decreased work of breathing (WOB) in dysenteric clients.
  4. Decreased work of the heart in clients with cardiac disease.
  5. To administer low/higher concentration of oxygen to patients.
  6. To allow uninterrupted supply of oxygen during activities like eating, drinking etc.

What are the factors responsible for oxygenation or Oxygen Therapy?

Factors Affecting Oxygenation:

Adequate of circulation, ventilation, perfusion and transport respiratory gases to the tissues are influenced by four types of factor:

1. Physiological factors:

Any condition that affects cardiopulmonary functioning directly affects the body’s ability to meet oxygen demand.

2. Developmental factor:

The developmental stage of the client and the normal aging process can affect tissue oxygenation, e.g. children are at risk of acute upper respiratory tract infections and exposure to these infections.

3. Behavioral factors:

A person’s behavior or lifestyle may directly or indirectly affect the body’s ability to meet oxygen requirements. Lifestyle factors that influence respiratory functioning include, nutrition (e.g. obesity and malnutrition), exercise (lack of exercise), cigarette smoking substance abuse (excessive alcohol, drug addiction), and stress (severe anxiety).

4. Environmental factor:

The environment can also influence oxygenation. The incidence of pulmonary disease is higher in smoggy, urban areas than rural areas. In addition client’s workplace may increase the risk for pulmonary disease. Occupational pollutions include asbestos, talcum powder, dust and airborne fibers leads to occupation diseases.

Definition of Intubation:

Intubation is the process of inserting a tube, called an endotracheal tube, through the mouth and then into the airway. This is done so that a patient can be placed on a ventilator to assist with breathing.

Intubation is the insertion of a tube, as into the larynx; the purpose of intubation varies with the location and type of tube inserted; generally it is done to allow drainage, to maintain an open airway, or to administer anesthetics or oxygen.

Complications of Endotracheal Intubation:

At the time of intubation:

  • Failed intubation,
  • Spinal cord and vertebral column injury,
  • Occlusion of central artery of the retina and blindness,
  • Corneal abrasion,
  • Trauma to lips, teeth, tongue and nose,
  • Noxious autonomic reflexes,
  • Hypertension, tachycardia, bradycardia and arrhythmia,
  • Raised intracranial and Swallowed ETT intraocular tension,
  • Laryngospasm,
  • Bronchospasm,
  • Laryngeal trauma Cord avulsions, fractures and dislocation of arytenoids,
  • Airway perforation,
  • Esophageal intubation,
  • Bronchial intubation.

While the ETT is in place:

  • Tension pneumothorax,
  • Pulmonary aspiration,
  • Disconnection and dislodgement,
  • Tracheal tube fire,
  • Unsatisfactory seal,
  • Leaky circuits,
  • Swallowed ETT.

During extubation:

  • Difficult extubation,
  • Cuff related problem,
  • ETT sutured to trachea or bronchus,
  • Laryngeal edema,
  • Aspiration of oral or gastric contents.

After intubation:

  • Sore throat,
  • Laryngeal oedema,
  • Hoarseness,
  • Nerve injury,
  • Superficial laryngeal ulcers,
  • Laryngeal granuloma,
  • Glottic and subglottic granulation tissue,
  • Laryngeal synechiae,
  • Vocal cord paralysis and aspiration,
  • Laryngo-tracheal membrane,
  • Tracheal stenosis,
  • Tracheomalacia,
  • Tracheo-oesophageal fistula,
  • Tracheo-innominate fistula.

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