From the Guidelines
Oxygen delivery devices should be chosen based on the patient's specific needs, with nasal cannulas being the most common interface for low-flow oxygen delivery, while Venturi masks and high-flow nasal cannulas are used for more precise control of oxygen concentrations and higher flow rates, respectively. The main types of oxygen delivery devices include:
- Nasal cannulas, which deliver low-flow oxygen (1-6 L/min) through prongs inserted into the nostrils, appropriate for patients requiring minimal oxygen support 1
- Simple face masks, which deliver 5-10 L/min with 35-50% oxygen concentration, used for patients needing moderate oxygen therapy 1
- Venturi masks, which provide precise oxygen concentrations (24-60%) at 4-15 L/min, ideal for COPD patients where controlled oxygen delivery is crucial 1
- Non-rebreather masks, which deliver high-concentration oxygen (60-90%) at 10-15 L/min, used for severely hypoxemic patients
- High-flow nasal cannulas, which can provide up to 60 L/min with 21-100% oxygen, used for patients who need high flow but cannot tolerate masks 1 The choice of device depends on the patient's oxygen requirements, underlying condition, comfort, and therapeutic goals, with providers typically starting with the least invasive option that meets the patient's needs and escalating as necessary 1.
From the Research
Types of Oxygen Delivery Devices
- Low-flow oxygen devices:
- High-flow oxygen devices:
- High-flow nasal cannulas (HFNC): deliver heated and humidified oxygen at flows up to 60 L/min, used for patients with severe hypoxemia 2, 4, 5
- Venturi masks: deliver oxygen at specific concentrations, used for patients who require a precise fraction of inspired oxygen 6
- Noninvasive ventilation (NIV) devices: deliver positive pressure ventilation, used for patients with acute respiratory failure 5
Indications for Use
- Low-flow oxygen devices:
- Used for patients with mild hypoxemia, such as those with chronic obstructive pulmonary disease (COPD) or pneumonia
- Used for patients who require supplemental oxygen during exercise or sleep
- High-flow oxygen devices:
- Used for patients with severe hypoxemia, such as those with acute respiratory distress syndrome (ARDS) or severe pneumonia 2, 4, 5
- Used for patients who require high levels of positive end-expiratory pressure (PEEP) or fractional inspired oxygen (FiO2)
- Used for immunocompromised patients with hypoxemic acute respiratory failure, although the benefits are still being studied 6
Comparison of Oxygen Delivery Devices
- HFNC vs. Venturi mask: HFNC may be better tolerated and more effective in delivering high fractions of inspired oxygen, but more research is needed to compare the two 4, 6
- HFNC vs. NIV: HFNC may be simpler to use and more comfortable for patients, but NIV may be more effective in delivering positive pressure ventilation 5