Pulmonary hypertension, a condition of high blood pressure in the lung’s arteries, places a burden on the heart. The right side of the heart must work harder to pump blood through these high-pressure vessels. Over time, this increased workload can weaken the right ventricle, leading to a reduced capacity to pump blood to the lungs for oxygenation. As a result, the body’s organs may not receive an adequate supply of oxygen, and oxygen therapy is a common treatment prescribed to manage the effects of this condition.
The Role of Oxygen in Managing Pulmonary Hypertension
Oxygen therapy is prescribed in pulmonary hypertension to counteract a state of low blood oxygen, known as hypoxia. In individuals with PH, the lungs can struggle to get enough oxygen into the bloodstream. When the body detects low oxygen levels, it triggers a counterproductive response: the small arteries in the lungs constrict. This narrowing, or vasoconstriction, further increases the pressure within the pulmonary arteries.
The increased pressure from vasoconstriction means the right ventricle must exert even more force to push blood through the lungs. Providing supplemental oxygen helps to break this cycle. The enriched oxygen is more easily absorbed into the bloodstream, raising oxygen saturation levels.
With higher oxygen levels in the blood, the pulmonary arteries are signaled to relax and widen. This vasodilation reduces the resistance the heart has to pump against, lowering the pressure within the lungs and protecting the right ventricle from being overworked. This intervention lessens symptoms like shortness of breath and fatigue and improves the delivery of oxygen to the body’s tissues.
Methods of Oxygen Delivery
The most common equipment for long-term home use is an oxygen concentrator. These devices, which can be stationary or portable, work by drawing in ambient air, filtering out nitrogen, and delivering a continuous flow of purified oxygen. Stationary units are larger, run on electricity, and are equipped with wheels for moving between rooms.
For more mobility outside the home, patients might use compressed gas tanks or liquid oxygen systems. Compressed gas tanks are metal cylinders filled with pure oxygen under high pressure. They contain a finite amount of oxygen, can be heavy, and require replacement or refilling when empty.
Liquid oxygen systems provide a higher volume of oxygen in a smaller, lighter container. These systems store oxygen in a very cold, liquid state, which turns into a breathable gas as it warms. A patient will have a larger reservoir at home and can fill a smaller, portable canister for use on the go. Oxygen is delivered to the patient through an interface, most commonly a nasal cannula—a small plastic tube with prongs that sit in the nostrils—or a face mask.
Prescription and Usage Protocols
A healthcare provider determines the need for oxygen therapy through tests that measure oxygen levels in the blood. One common, non-invasive method is pulse oximetry, which uses a small clip-like device on the finger to estimate oxygen saturation. This test is performed at rest and during a six-minute walk test to see how oxygen levels respond to physical exertion. A more precise measurement can be obtained from an arterial blood gas (ABG) test, which analyzes a blood sample taken directly from an artery.
Based on these results, oxygen is prescribed at a specific flow rate, measured in liters per minute (LPM). Patients must not adjust this flow rate without consulting their doctor, as it is calibrated to their specific needs. The prescription will also detail when the oxygen should be used.
Some individuals require continuous therapy, using it 24 hours a day. Others may need nocturnal therapy, using oxygen only during sleep when breathing patterns can cause oxygen levels to drop. Another group may be prescribed exertional therapy, meaning oxygen is used only during physical activities to meet the body’s heightened demand.
Integrating Oxygen Therapy into Daily Life
Safety is a primary concern with oxygen therapy. Oxygen itself is not flammable, but it greatly accelerates combustion, so it is important to avoid open flames. This includes a strict no-smoking policy for the patient and anyone nearby, and keeping oxygen equipment away from gas stoves, candles, fireplaces, and other heat sources. Posting “Oxygen in Use” signs can help alert visitors to these precautions.
Mobility requires some planning, but portable systems are designed to facilitate an active life. Managing the tubing to avoid trips and falls becomes a daily routine. When traveling, it is necessary to coordinate with airlines, bus companies, or cruise lines well in advance, as they have specific policies for oxygen use. Your oxygen supply company can assist in making these arrangements and ensuring you have the necessary equipment for your trip.
Regular maintenance of the equipment is also part of the routine. To prevent respiratory infections, nasal cannulas and masks should be cleaned regularly according to the manufacturer’s instructions. The oxygen supplier handles the long-term maintenance of machinery, such as concentrators, ensuring they continue to function correctly and safely. Regular check-ins with your healthcare team will ensure your prescription remains appropriate for your condition.