Hyperoxia and Oxygen Toxicity

The risks of Hyperoxia and oxygen toxicity.
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In this lesson we are going to talk about some of the risks that come with the use of oxygen, specifically when the concentrations are above 60% FiO2. While oxygen is essential to care for patients, especially the very sick, there are potential consequences to its use and this lessons goal is to cover some of those risks and complications that could potentially result.
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#ICUAdvantage #OxygenToxicity #Hyperoxia

[@ICUAdvantage]

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[@syedasamiyahmubashir5595]

Thank you soooo much for the video. Plss never loose the motivation to upload such content. We are always and forever rooting for your workk

[@ICUAdvantage]

Truly my pleasure and thank you for that! Great to hear that and I appreciate it.

[@miki97xde]

I love this channel, mainly because (At the moment) i am a care assistant, not a nurse, so my responsibilities and expected knowledge is much, much lower, but with the knowledge I get from these videos I was literally able to convince people to reevaluate their decisions, and thus most likely implement a better care. As much as this is obvious, I think you have managed to save at least couple of lives with your videos.

[@ashleypeach960]

Currently studying for my CCRN and was thinking that I don't know all that much about this topic. This video was extremely helpful and I look forward to watching more. I am a PICU nurse, so I also wanted to add that premature infants are also extremely susceptible to this due to a lack of antioxidant defenses. It can cause Bronchopulmonary dysplasia (BPD) from the fibrotic tissue build up and Retinopathy of prematurity (ROP) due to retinal vasoconstriction.

[@SaltyRad]

I don’t even work in the ICU. I just herd about oxygen toxicity and was curious and your the first channel that popped up. Thankyou for satisfying my curiosity and teaching me something

[@MHairi-lj4dt]

Yay! A new lesson video! Thanks Eddie! You made my day! 😊

[@ICUAdvantage]

Woohoo! Happy to help :)

[@christophermccarthy4380]

I had what is called a catastrophic event that led me to being a o2,however soon after I quit smoking and the o2 went up so quickly I didn't realize what was happening to me. I found that if I had a cigarette the symptoms would abate for a while. Now here's what is really bad. I went to medical school and knew the symptoms of o2 toxicity but the confusion was so bad I couldn't put 2+2 together. I have taken myself off the o2 and already I am seeing positive results. I won't know for a few days weather I will have to go back on o2 but if I do it will be at a much lower rarate. Your information confirms my suspicions that you

[@davidmbeckmann]

Very nicely done. Excellent explanation. I have encountered critical care docs who thought it was the Pa02 and not the pA02 that matters! I have seen lots of CoVid patients stuck on high flow at 80 to 90% for days and days. High flow by it's nature provides 100% of the patients flow with NO entrainment of ambient air. The RT's and docs thought the CoVid was worsening... I never use, long term, high flow greater than 60%, managing further hypoxia with CPAP. CoVid patients have taught us that most folks tolerate hypoxia, ( without hypercapnia ), very well and it's not the immediate emergency we were all taught...after all, Mt. Everest has been climbed without oxygen.

[@ICUAdvantage]

Its interesting the ARDSNet recommendations have stood at 88%+ for sometime, but even in the past we rarely let them ride there. COVID definitely has opened our eyes to a lot of things and it'll be interesting to see what other practice wide changes come from it all. And very true and interesting point about Mt Everest!

[@nupuruils]

I didn't know about oxygen toxicity until day 3 of my HBOT. I asked my doctor to give me air breaks every 30 minutes. She dismissed my chance of getting a seizure, hence, denied air breaks. I think I'm quitting hbot because finding another place to do it, and to do it right, is also not so easy.

[@tmsthailand]

So, as we know 100% O2 is toxic below 6m underwater. Therefore, how come it's ok to use 100% O2 in a hyperbaric chamber for patient care? After all, they compress down to a simulated depth of 10m underwater, yet there are no side effects to the patients (other than maybe eye tissue issues etc). And in a hospital setting patients are put on cranula for hours on end with the point of aiding in the recovery of the patient. As we know 100% O2 is diluted either through use of cranula or nasal mask to around 40-70%. It seems there are so may variables and no hard-and-fast rule. Has there been any research done? In America you can buy O2 in a small 2l tank without any FDA approval and people can just take a hit whenever they want.

[@TrainerAQ]

It's gotta be a situation where the patient is very low on oxygen. I know as a pilot, we used 100% O2 in case of a decompression and above 40,000ft we even pressure demand systems, where Oxygen is forced into the lungs in order to create the pressure necessary for our bodies to actually take in the oxygen at a cellular level.

[@lobarita]

Thank you for simplifying this complex topic

[@ICUAdvantage]

Thanks Jacob!

[@HM02Fly223]

Another great video Eddie! I was wondering if you’ll be able to make a video about lumbar drains? (My new job requires me to handle them more often then not). Thanks!

[@ICUAdvantage]

Glad you liked it. I do have lumbar drains on the todo list. Are you working neuro ICU or doing them post TAA?

[@HM02Fly223]

@@ICUAdvantage Great! Post TAA, I recently started working on a CVICU floor.

[@billy-jadeachiu2296]

Thanks for this video...I've mentioned your channel to a number of co-workers and other healthcare workers...hope all is going well in NC...be safe 🤙🤙🤙

[@ICUAdvantage]

Thank you so much! I really appreciate you helping to spread the word. And yes, things are going well here! Hope you are doing well yourself.

[@roland.j.ruttledge]

Always informative, many thanks UK

[@ICUAdvantage]

Appreciate that Roland!

[@pennysharp6584]

Thanks soo much for great info. Your time ,and study.

[@ICUAdvantage]

Truly my pleasure. Glad you liked it!

[@elisabetejardim9446]

Great presentation of this topic! I just subscribed to you channel! Thank you! 👏🏼👏🏼👏🏼

[@ICUAdvantage]

Thank you! And WELCOME!

[@thomasvedhamuthuravindran4758]

Praise the lord Bro/Sis, . Tkq for posting your valuable information videos .

[@ICUAdvantage]

You're welcome and glad you liked it!

[@RileyAicher1]

Recently bought a shirt from your store and I love it! Great work

[@ICUAdvantage]

Awesome! Thanks so much for that support and glad you are loving the shirt!

[@lobarita]

Thank you!!! Great pace and videos

[@ICUAdvantage]

Appreciate this!

[@sunitasimkhada6387]

Thank you 🙂

[@ICUAdvantage]

You're welcome Sunita!

[@venkatramanayyar2192]

Very nicely explained 👌

[@ICUAdvantage]

Glad you liked it

[@ericperry28able]

Just bought a oxygen tank I don’t really need it I’m healthy it’s 99.999% pure oxygen my plan is to take it for 30 mins 3 times a week just to better my cells and body in general my only concern is this topic specially and my goal is to avoid the toxicity but to achieve the other benefits please ignore my lack of punctuation however I’m sure there is a good balance some companies use 92% to 97% to decrease the negative side effects however I have 99.999 so I don’t have that option my question is whether to shorten the dose to less than 30 mins per session 5 times per week or does it have to do more with the regulator pressure

[@LeeLee-su9hp]

Did you monitor it with a pulse oximeter?

[@Mikesworld777]

That’s not gonna do much for you. You should try hyperbaric oxygen therapy 5 days a week 90-120 min at 2-2.5 ata

[@reynaadrianagarcia3716]

Love your voice!

[@ICUAdvantage]

Thanks Reyna!

[@dunktherapper]

I haven’t finished the video yet but would this hyperoxia increase d dimer?

[@tbaby24740]

Yes I'd like to know this answer also??

[@Mario-rx4xt]

Love your video! What could it be a great hypothesis to investigate in nursing field (other medicine) about hyperoxia. THANK YOU !

[@ICUAdvantage]

Glad to hear it Mario! Pretty interesting topic for sure.

[@lalohernandez5582]

Great video can I ask can you have oxygen toxicity if your pa02 less than 100?

[@michaelburatovich3199]

Eddie, can N-acetylcysteine mitigate hyper-oxygen damage? If see some animal studies

[@Ur-HarkonThePainSeeker]

Can a panic attack with hyperventilation cause mild hyperoxia (high oxygen presence in blood)

[@ICUAdvantage]

No, its about the concentration of O2 delivered in the air.

[@Ur-HarkonThePainSeeker]

@@ICUAdvantage thank you, I appreciate the help.

[@Chriscedeno]

Thanks!

[@ICUAdvantage]

Thank you so much for this Chris!

[@user-nq8hz7hx5y]

Eddie, thank you, fascinating explanation as usual! What do you think about using high FiO2 during total CPB? I think that if the whole venous blood is drained into the cpb, bypasses heart and lungs, and pumped into an aorta, we can use high FiO2 for few hours without any big consequences, because the lung capillaries and alveolar membrane don't touch with hyperoxic blood. Do you agree with that?

[@ICUAdvantage]

Thank you! So yeah I think your thinking is correct. Our big concern is high levels for extended periods of time, aka total dose delivered. As well as the big concern is the interaction of the high partial pressure of O2 in air with the alveolar epithelial and capillary endothelial cells.

[@lorenzogaerlan3837]

Perfect!!!

[@ICUAdvantage]

Thank you!

[@discardedvetdoc]

What about intermittent oxygen? My levels drop to 90 2 years ago. to 80 1 year ago and 70 now. It isn't permanent it is intermittent. It doesn't always happen with exertion but now it is starting too.... it also happens when i am doing nothing. I have searched for anything on this and there is nothing.... My pulmonologist has me on 4L for night time and exertion. He says not to use it when I am sitting probably for these reasons but i sometimes have low oxygen sitting.. my tissues/cells dont care if I am sitting or not they need oxygen. I do feel like I am getting rest now when i sleep and my levels are stabilized above 90 riding like 90-94 while sleeping.. I tried to search about intermittent oxygen and I dont find any information about it anywhere... I am a military veteran exposed to lots of toxins...

[@mraravindd8446]

Impressive👍

[@ICUAdvantage]

Ty!

[@user-nq8hz7hx5y]

Thx!!!

[@ICUAdvantage]

You're welcome!

[@derryckdelange4710]

you are epic , have a great day 😀

[@ICUAdvantage]

Thanks! You too!

[@coco22ism]

So do you think using High flow Oxygen for covid patients (in the order of >20L/min) might be causing further damage to the remaining lung tissue?

[@coco22ism]

Higj flow with high fi02 (in the order of >0.6) ofcourse.

[@ICUAdvantage]

The risk is certainly a possibility, especially when they've been on it for a long period of time, which I know many have. Again, its a balance, because sometimes a high FiO2 is required to prevent life-threatening hypoxia. Other strategies such as CPAP/BiPAP or intubation may help reduce FiO2 requirements by adding higher PEEP.

[@coco22ism]

@@ICUAdvantage thanks immensely..anothet question, still regarding covid..based on your experience, you reckon early intubation or bipap/cpap for a lower fi02 is better than the high flow? Or as you mentioned finding the balance is key... thanks again

[@ICUAdvantage]

@@coco22ism tough call and I think the jury is still out on knowing for sure. I can only speak anecdotally but it seems like there’s some evidence supporting CPAP/BiPAP if you can.

[@coco22ism]

@@ICUAdvantage thanks alot!! Keep it up! Love your content!!

[@chrisg4932]

yo first of all very helpful, how does this relate to age? Oxygen therapy is often used in the NICU because oxygen helps vasodilate the pulmonary vessels with seemingly little worry for oxygen toxicity. is there an increase risk for atelectasis in older patients/ is there more serious complications?

[@chrisg4932]

I am in nursing school and was taking care of a patient that was prescribed 100% oxygen therapy for 24 hours.

[@ICUAdvantage]

Great question, and I don't know if I know the answer. I am just not versed with neonates and peds to know if there are other mechanisms that would reduce the risk of such therapy in the young. The ROS is a by product of ATP production and occurs even at normal levels and increases with increased tissue Hyperoxia to the point where it overwhelms the anti-oxidant balance. I would think the same processes are taking place, but perhaps the management and levels work different in the young. That said, 24 hours generally isn't a huge concern. Remember its all about cumulative dose, so the higher the longer, the increased the risk.

[@nhilistickomrad4259]

Medicine is all a balancing act. If someone makes a statement it comes with a lo g list of caveats. Most important of which is saving of life.

[@quazar1498]

So rinsing teeth with hydrogen peroxide is bad? Because of the oxygen released?

[@ICUAdvantage]

No, unrelated.

[@emergencyandcriticalcare2044]

Hi Eddie i use 85%Fio2 with 55ltr/min in high flow nasal cannula and inj enoxiperin od for first 48 hour then vening at 5 ltr per 12 hour in covid pt for 15 day who has happy hypoxia having 50%spo2 on room air after treatment they have 98%. Is there any condition to have any tissues damage or any .bcos I haven't seen any plz guide me sir....

[@ICUAdvantage]

I think the takeaway is that its just something that poses added risk, but not necessarily that everyone will develop complications as a result. Again, sometimes the Hyperoxia is a requirement to treat hypoxemia.

[@nathancapman]

Yes!

[@ICUAdvantage]

TY!

[@crawfordviolin]

Can deep breathing exercises put someone in hyperoxya? Or is this something that can only happen using supplemental O2?

[@ICUAdvantage]

No, this is more a concern for treatment in the hospital.

[@Adri-dj9ve]

@@ICUAdvantage so if u breath too much oxygen u can’t die? I’m scared now

[@itrop9952]

Is this video was published by one of your subscriber who lost his father and emailed you?

[@ICUAdvantage]

?

[@craigryan5290]

How nice someone made up a new name for oxygen toxicity ?

[@hannabailey434]

liked and subs

[@ICUAdvantage]

Awesome! Welcome Hanna!

[@autojagatwithvineet3053]

👍👍

[@ICUAdvantage]

Thank you!

[@davidpetersonccp9077]

LETS NOT BE MISLEADING THERE IS ANOTHER AVENUE FOR O2 THERAPY