Transcription of แนวทางปฏิบัติการรักษาด้วยออกซิเจน (Oxygen therapy)
1 1 2 3 5 6 ( oxygen therapy) 7 (Humidity and aerosol therapy) 16 (Chest physiotherapy) 34 (Suctioning and nasal irrigation) 44 (Tracheostomy care) 55 62 2 .. 1: ( oxygen therapy) .. 2: (Humidity and aerosol therapy) .. 3: (Chest physiotherapy).
2 3 4: (Suctioning and nasal irrigation) .. 5: (Tracheostomy care) .. 4 1. 37 2. 5 - - Pubmed - 3. 4.
3 5. 6. 7. 5 (Level of evidence) I randomized controlled trials systematic review 1 II non-randomized controlled trials before & after clinical trials cohort studies III case-control studies IV descriptive, case reports case series V expert opinion (consensus).
4 (Level of evidence) Cochrane data base study, Oxford cetre for evidence-based medicine 2001 ( ) School of Health and Related Research, University of Sheffield, UK (source: (Grade of recommendation) A (Strongly recommended) B (Recommended) C (Optional) D (Not recommended in normal situation) E (Not recommended in all situations) : (Grade of recommendation) CPG Classifying recommendations for clinical practice guidelines, American Academy of Pediatrics Pediatrics 2004; 114: 874-877 6 ( oxygen therapy) ( oxygen therapy) (hypoxia) 2 - (Acute care setting) - (Home oxygen therapy) I.)
5 (Acute care setting) (Level V, Grade A) - (PaO2 < 60 . SpO2 < 90% PaO2 < 50 . SpO2 < 88% room air) - - (pneumothorax) - (flow rate) 2 1. Variable performance (low-flow) system flow rate, nasal cannula, face mask, oxygen hood oxygen tent 2.
6 Fixed performance (high-flow) system , oxygen blender air-entrainment venturi mask ( oxygen delivery device) Nasal cannula 2 / (Level V, Grade A) 6 / (Level V, Grade A) (Level V, Grade A ) 7 face mask (Level IV) - nasal prong - nasal prong - - nasal prong (continuous positive airway pressure)
7 - - nasal cannula Simple face mask 35%-50% flow rate 5-10 / 5 / mask (Level V , Grade A ) (Level IV) - - mask - oxygen flow rate Partial-rebreathing mask simple face mask partial rebreathing mask reservoir bag 40%-60% 6-10 / (Level V, Grade A)
8 Reservoir bag Non-rebreathing mask partial-rebreathing mask valve 2 mask valve reservoir bag reservoir bag valve valve 8 mask partial rebreathing mask 60%-80% flow rate 10 / (Level V , Grade A ) oxygen hood 30%-70% hood, 7 / (Level V , Grade A ) oxygen hood flow rate 3-5 / flow rate 3 / oxygen hood (air) (Level V, Grade A)
9 oxygen hood oxygen analyzer (Level V , Grade A ) hood hood (Level IV) - - oxygen hood - oxygen hood cold stress overheat oxygen tent croup 10-15 / 40%-50% (Level V, Grade A) - oxygen tent (Level IV) - oxygen tent - oxygen tent - 9 1.
10 , flow rate, FiO2 humidifier Flow rate( / ) FiO2 (%) Humidifier Nasal cannula : < 2 : < 6 24%-40% Bubble humidifier Simple mask 5-10 35%-50% Bubble humidifier Partial-rebreathing mask 6-10 40%-60% Bubble humidifier Non-rebreathing mask 10 60%-80% Bubble humidifier oxygen hood* 7 30%-70% Jet nebulizer oxygen tent 10-15 40%-50% Jet nebulizer * oxygen hood flow rate 3-5 / . ( oxygen cylinder) chrome molybdenum steel 2,200 psi 2 2: ( ) factor for duration of flow (L/psi) ( flow rate 1 L/min) D 5 E 22 10 G 187 88 H 244 115 oxygen concentrator (molecular sieve material) polarity 80-95% flow rate 1-5 / flow rate 10 / (Level IV, Grade A) 10 Liquid oxygen 1.
