Occupational Diseases / / August 12, 2017
Principles of treatment
1. Treatment with oxygen should be started early in hypoxic condition.
2. Oxygen therapy should be prolonged.Lack of oxygen in the arterial blood is easily compensated (for 5-10 min), however, upon termination of inhalation of oxygen 5-10 min hypoxemia occurs again.To eliminate the oxygen debt tissue takes a long, many hours of continuous administration of oxygen.
3. Taking into account the possibility of hyperoxia and its negative effect, oxygen in high concentrations (80-100%) should be given only if the testimony of life in the event of rapid development of acute oxygen starvation (eg, intoxication CO).Continuous inhalation of high concentrations of oxygen is shown for no more than 2-3 hours. Sudden changes in the oxygen content in the inspired mixture can cause deterioration of the patient.Therefore, when using high oxygen concentrations should first go to a low, and only then to stop the supply of oxygen.Mostly enough breathing oxygen-air mixture with 40-60% oxygen conte
4. Oxygen therapy should be used not in isolation but in conjunction with a general antidote therapy, antibiotics, vitamin therapy, and so on. D. Humidification of oxygen is not required.
5. Meets Increased individual sensitivity to oxygen patients in which there are anxiety, headache, shortness of breath, convulsions, marked drop in vascular tone, and others. In these cases, oxygen therapy should be stopped.
Oxygen therapy with intoxication irritant poisons and smothering action (chlorine, sulfur dioxide, nitrogen oxides, etc..).
poisons of this group cause profound destructive changes in the airways and in the lung tissue, until the pulmonary edema.For hypoxia (pulmonary arterial) joined hypoxia circulatory disorders, and develops the mixed form of hypoxia.Oxygen starvation of the organism begins with the first minutes of intoxication and sharply exacerbated the toxic stage of edema.Hence the need for the introduction of oxygen in the reflex period, even with weakly expressed phenomena.This is achieved by: a) removal of hypoxemia in the early stages;b) the creation of the body of more favorable conditions in the case of toxic pulmonary edema.The recommended concentration of 40-60%.oxygen supply - 8.10 liters per 1 min.
Toxic pulmonary edema leads to a profound disturbance of tissue metabolism.Normalization of exchange changes is slow, which is why it takes a long introduction of oxygen during the hours and days.
Oxygen therapy in cases of poisoning by carbon monoxide
When exposed to carbon monoxide is formed carboxyhemoglobin in the blood.The cleavage and elimination of carbon monoxide at high oxygen partial pressure are faster.During the first 3 hours of vital shown high concentrations of oxygen (80% and above).
In severe forms of intoxication complete separation of carbon monoxide occurs during the first day.In addition, it is developing pulmonary arterial, circulatory and tissue hypoxia.
Oxygen therapy during intoxication metgemoglobinoobrazovatelyami.
When exposed to a fairly large group of poisons (nitro aniline, nitrobenzene and others.) Hemoglobin is converted to methemoglobin.
During the first 3-4 hours karbogenoterapiya used (15 min) in combination with the oxygen concentration in the inhalation of 70-80% for 40-60 minutes.Subsequently, only inhaled oxygen (40-60%) but 1-2 hours 2-3 times a day.
Oxygen therapy during intoxication hemolytic effect poisons
Some poisons (potassium chlorate -. Bertoletova salt, arsenic, hydrogen, etc.) cause extremely severe hypoxemia due to the developing hemolysis.There is an acute toxic hemolytic anemia, the oxygen supply is greatly disturbed.In the first 2-3 hours of intoxication for increasing the content of oxygen dissolved in the plasma it recommended last inhalation of high concentrations (80-90% or more), then switching to a concentration of 40-60% (long, short interruptions clock).
Oxygen therapy for cyanide poisoning
When intoxication Cyanide is a rapid development of acute oxygen starvation - histotoxic (tissue) hypoxia.Antidote therapy is performed on the background oxygen therapy (inhaled oxygen in high concentrations - 80% or more).Inhalation should be started from the very first minutes of intoxication and in the first 2-3 hours carried out continuously.In subsequent use lower concentrations (40-60%) is long, the patient intermittently on state.
Oxygen therapy during intoxication
organophosphate mixed hypoxia develops in intoxication by organophosphorus compounds.Oxygen starvation of the body is due to the disorder of breathing (with spastic component), vascular disorders.Oxygen removes hypoxia, restores the functional condition of the central nervous system, relieves cramps, bronchospasm.