Oxygen Therapy SK Jindal, Ritesh Agarwal
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1Oxygen Therapy
2Oxygen Therapy
Second Edition
Edited by S K Jindal Professor and Head Department of Pulmonary Medicine Postgraduate Institute of Medical Education and Research Chandigarh Ritesh Agarwal Assistant Professor Department of Pulmonary Medicine Postgraduate Institute of Medical Education and Research Chandigarh
Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Oxygen Therapy
© 2008, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photo copying, recording, or otherwise, without the prior written permission of the editors and the publisher.
First Edition: 1998 (North India Chapter, American College of Chest Physicians, Chandigarh)
Second Edition: 2008
Typeset at JPBMP typesetting unit
Printed at Paras Press
4Contributors 6Preface to the Second Edition
The first edition of the book on Oxygen Therapy was received with a welcome note by the medical community especially the students pursuing their postgraduate courses in Medicine and Chest Diseases. It is now nearing a decade since the first edition of this book was published. Numerous advances have taken place during this period. The reliance on oxygen therapy has enhanced and indications expanded. Some of the broad areas in which the progress has been specially noticeable include the long-term use of domiciliary oxygen, the hyperbaric oxygen therapy and the alternate oxygen carriers. There are also several advancements in oxygen delivery devices and the related equipments. The understanding of the side effects and the toxicity of oxygen has also increased. Oxygen being an environmental gas, is significantly influenced by natural changes in the environment. One can foresee the widening arena of oxygen use in the light of developments in medicine and physiology which have taken place during exploration and exploitation of different environments, example at high altitude and in the space on one hand and in the depth of the seas on the other. Obviously therefore, there was a great need of a revision.
In the revised edition, we have taken care to include some of the new scientific developments as well as update the information on other subjects. We have also included the contributions from several other authors and experts to whom we express our sincere gratitude. This book provides short but concise information on different aspects of oxygen meant as a therapeutic agent. It lays the scientific foundations on oxygen therapy, primarily for the clinicians. It also lays stress on a rational and well regulated use of oxygen as a core drug than a mere add on tonic. We sincerely hope that the readers will enjoy the reading and find the book useful in their day-to-day practice of medicine.
SK Jindal
Ritesh Agarwal
7Preface to the First Edition
Oxygen as a gas, has fascinated me since my early childhood which was spent in the neighborhood of a vendor who used to supply gas cylinders for welding and other miscellaneous, nonmedical uses in a small town. Later, I was overwhelmed by the immense faith and confidence which oxygen enjoyed as a last ritual of a patient on the death-bed. The span of life in Hindu philosophy has been linked with the number of breaths, and oxygen alluded to as a “Prana-Vayu” (the life-air). People, therefore, expect miracles from oxygen.
Oxygen therapy plays a pivotal role in the management of respiratory, cardiac and other serious illnesses. Indications for Oxygen Therapy continue to expand. Numerous advances have been made in the understanding of both the physiological and clinical aspects of oxygen. Yet it remains one of the most ill-practised subject in clinical medicine. Its administration is erroneously identified with placement of a nasal catheter (or a face mask) attached with a tube to an oxygen cylinder. There is much more to know about oxygen.
There is a great lack of information on oxygen and its uses. There are plenty of reviews and comprehensive books on different aspects of Respiratory Failure and Oxygen Therapy. But a third-world perspective is often lacking. The present monograph is an attempt to collate this information and intermix with our own experience at this Institute, in a single volume which covers the physiological and pharmacological basis of Oxygen Therapy as well as the practical aspects related to its administration.
The monograph is intended for use of not only the graduate and postgraduate students, but also the practicing physicians and other specialists. It should particularly interest internists and physicians who practice general and/or pulmonary medicine, critical care, pediatrics, cardiology and other specialities wherever oxygen is required. To make it more relevant for clinicians of all hues, it includes chapters on different aspects such as hyperbaric 8therapy, oxygen use for non-pulmonary diseases, during air travel and at high altitude, and special considerations for the neonates. It is hoped that the readers shall enjoy the book and benefit from its reading.
SK Jindal