Oxygen therapy: important considerations.

Oxygen therapy is one of the most critical consideration in the management of diseases crossing different medical and surgical specialities. But this is one subject which remains poorly understood and inadequately practiced. Invariably, enormous errors are committed in the use of oxygen.1-3 Oxygen prescription often comprises of a single written word — oxygen. Frequently, it is administered merely on verbal orders. Reports on assessment of uses and misuses of oxygen are almost universal including those from the developed countries of the West.4-6 We have ourselves found gross inadequacies in oxygen-prescription on analysis of over a hundred indoor files and treatment charts.7 A comprehensive overview of the subject is, therefore, important to rationalise treatment and achieve the maximum benefits.7 Oxygen is an atmospheric gas essential for survival of all living things. The presence of an “air” vital for survival of humans was recognised in the ancient Greek as well as in Vedic Hindu literature more than 2000 years ago.8,9 But it was only in the eighteenth century that the gas was isolated by Joseph Priestley and its importance in respiratory physiology was described by Antoine Lavoisier.10 Rapid developments took place in the subsequent years. The problems of oxygen deficiency as well as the need and indications for oxygen therapy were subsequently recognised. Soon, oxygen came to be known as a ‘cure all’ medicine used for conditions varying from cholera, arthritis, anaemia and syphilis to glaucoma, epilepsy, diabetes and cancers. It was around second decade of the twentieth century and later that the oxygen therapy was adopted for indications based on firm scientific foundations.11