Oxygen Therapy Guidelines

Introduction to Oxygen Delivery Methods

The American Thoracic Society recommends nasal cannulae for medium-concentration oxygen therapy in adults because they are preferred by patients for comfort and are less likely to be removed during meals 4, 5.
The American Academy of Pediatrics suggests that nasal cannulae are preferred for most infants requiring oxygen therapy because they provide more consistent oxygenation during feeding and handling, and improve growth compared to oxygen hoods 1, 2.

Nasal cannulae are recommended for infants and children requiring supplemental oxygen therapy, with flow rates of 0.25 to 3 L/min achieving similar pulmonary artery pressure reductions as oxygen hoods with FiO2 >0.80 1, 2.
High-flow nasal cannula (HFNC) is recommended for infants with moderate to severe bronchiolitis as it is safer and more effective than low-flow oxygen, and for patients requiring medium to high-concentration oxygen therapy who are not at risk of hypercapnia 3.

Nasal cannulae are recommended for adults requiring medium-concentration oxygen therapy, with flow rates adjusted between 2-6 L/min to achieve desired saturation 4.
Venturi masks are recommended for adults requiring precise control of FiO2, especially those at risk of hypercapnic respiratory failure, and when a constant FiO2 of 24%, 28%, 31%, 35%, 40%, or 60% is needed 4, 5.
High-concentration reservoir masks at 15 L/min are preferred for critically ill adults until reliable pulse oximetry monitoring is established 4, 5.

The American Thoracic Society suggests assessing patient age and clinical condition, including severity of respiratory distress and risk of hypercapnic respiratory failure, to determine the appropriate oxygen delivery method 2, 4, 5.
Target SpO2 ranges are recommended as follows: 90-97% for infants with bronchiolitis, 94-98% for most adults, and 88-92% for those at risk of hypercapnia 6.