As mentioned, room air is 21 percent oxygen, so you are breathing a FiO2 of 21 percent without supplemental oxygen. When you use a flow rate of 1 liter per minute, your FiO2 increases to 24 percent. Every liter beyond that increases the FiO2 by about 4 percent.
Liter flow is the flow of oxygen you receive from your oxygen delivery device. This flow of oxygen is measured in liters per minute, or LPM.  Every liter per minute of oxygen increases the percentage of oxygen provided to the patient by about 3-4%.
WHITE = 4-6L/min = 28% O2. YELLOW = 8-10L/min = 35% O2. RED = 10-12L/min = 40% O2. GREEN = 12-15L/min = 60% O2.
Normally, oxygen saturation levels between 94-98% are considered to be sufficient. In moderate to serious cases, where oxygen therapy is the ONLY form of treatment doled out, doctors/ patients and caregivers should aim at achieving 92-96% SP02 levels at room air.
Administering too much oxygen to these patients could slow down breathing so it’s important to work with a pulmonologist. “Giving these patients anything more than two or three liters a minute could be risky and requires closer monitoring,” he added.
The normal flow rate of oxygen is usually six to 10 litres per minute and provides a concentration of oxygen between 40-60%. This is why they are often referred to as MC (medium concentration) masks, as 40%-60% is considered to be a medium concentration of oxygen.
High-flow nasal cannula (HFNC) therapy is an oxygen supply system capable of delivering up to 100% humidified and heated oxygen at a flow rate of up to 60 liters per minute.
Room air is 21% O2. So if a patient is on 4 L/min O2 flow, then he or she is breathing air that is about 33 – 37% O2. The normal practice is to adjust O2 flow for patients to be comfortably above an oxygen blood saturation of 90% at rest.
In Conclusion patients with COVID-19 requiring oxygen therapy need long-term inpatient care with a median of 12 days in hospital including 8 days on supplemental oxygen, which should be taken into account when planning treatment capacity.
FiO2: Percentage of oxygen in the air mixture that is delivered to the patient. Flow: Speed in liters per minute at which the ventilator delivers breaths. Compliance: Change in volume divided by change in pressure.
When oxygen levels become low (oxygen saturation < 85%), patients are usually intubated and placed on mechanical ventilation. For those patients, ventilators can be the difference between life and death.
Flow rates of 1-4 litres per minute are used with nasal cannulas, equating to a concentration of approximately 24-40% oxygen.
Some COVID-19 patients may show no symptoms at all. You should start oxygen therapy on any COVID-19 patient with an oxygen saturation below 90 percent, even if they show no physical signs of a low oxygen level. If the patient has any warning signs of low oxygen levels, start oxygen therapy immediately.
Conventional low-flow devices (e.g., nasal cannula or simple face mask) provide 100% FiO2 at a maximum of 15 liters per minute. Even during quiet breathing, inspiratory flow rates are approximately 30 liters per minute, which exceeds supplemental oxygen flow (3).
Oxygen therapy in the acute setting (in hospital)
Therefore, give oxygen at 24% (via a Venturi mask) at 2-3 L/minute or at 28% (via Venturi mask, 4 L/minute) or nasal cannula at 1-2 L/minute. Aim for oxygen saturation 88-92% for patients with a history of COPD until arterial blood gases (ABGs) have been checked .
Oxygen concentrators: Oxygen concentrators are also available for home use. There are “low flow” concentrators, delivering 1 to 5 liters per minute of oxygen, and “high flow” concentrators that go up to 10 liters per minute. An oxygen concentrator is an electrical device about the size of an end table.
People who are breathing normal, who have relatively healthy lungs (or asthma that is under control), will have a blood oxygen level of 95% to 100%. Anything between 92% and 88%, is still considered safe and average for someone with moderate to severe COPD.
If you are using an at-home oximeter, you should contact your health care provider if your oxygen saturation level is 92 percent or lower. If it falls to 88 percent or lower, seek immediate medical attention. If you have questions about your results, talk to your health care provider.
Normal: A normal ABG oxygen level for healthy lungs falls between 80 and 100 millimeters of mercury (mm Hg). If a pulse ox measured your blood oxygen level (SpO2), a normal reading is typically between 95 and 100 percent. However, in COPD or other lung diseases, these ranges may not apply.
Some people may need to be on a ventilator for a few hours, while others may require one, two, or three weeks. If a person needs to be on a ventilator for a longer period of time, a tracheostomy may be required.
When using the ventilator a PS of 5 – 7 cmH2O and 1-5 cmH20 PEEP (so called ‘minimal ventilator settings’) will overcome increased work of breathing through the circuit (i.e. ETT) If still on the ventilator the patient should have ‘minimal ventilator settings” Initial trial should last 30 – 120 minutes.
A ventilator mechanically helps pump oxygen into your body. The air flows through a tube that goes in your mouth and down your windpipe. The ventilator also may breathe out for you, or you may do it on your own.
A normal level of oxygen is usually 95% or higher. Some people with chronic lung disease or sleep apnea can have normal levels around 90%. The “SpO2” reading on a pulse oximeter shows the percentage of oxygen in someone’s blood. If your home SpO2 reading is lower than 95%, call your health care provider.
A normal oxygen saturation level is 97-100% but older adults typically have lower levels than younger adults. If an individual is older than 70, a normal oxygen level for elderly adults may be about 95%, which is acceptable. In extreme cases, low oxygen levels can result in hypoxemia or hypoxia.
A higher level of applied PEEP (>5 cmH2O) is sometimes used to improve hypoxemia or reduce ventilator-associated lung injury in patients with acute lung injury, acute respiratory distress syndrome, or other types of hypoxemic respiratory failure.
The answer is no! The oxygen flow metre is connected to either a bottle of oxygen or a medical wall supply of oxygen. This oxygen is pure: it is 100% oxygen! Therefore, anything that comes out of that oxygen flow metre has an FiO2 of 100%.
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