(12-27-2013 06:43 PM)justMongo Wrote: Because my PsaO2 levels were low throughout my sleep study, in addition to a BiLevel machine, my doc prescribed 2 LPM of O2 be injected into the CPAP flow from a concentrator.
He admonished me not to set the O2 levels too high.
… I'm wondering if his admonition is in regard to equipment or to physiologic effects of an atmosphere too rich in O2.
Too much O2 in the blood can create problems -- more oxidation, more free radicals, can render prescription medications ineffective, things like that. At many hospitals they are careful not to give too much O2 to patients nowadays, because of the problems too much O2 was causing years ago.
If you are using O2 nightly then I would recommend wearing occasionally a recording pulse oximeter (like perhaps weekly, and also whenever you are sick or changing medications), so you can see (and keep your doctor informed) what your O2 levels are throughout the night.
This year one member of Apnea Board reported she was able to get her insurance to pay for a prescribed Pulse Oximeter setup for her ResMed S9 machine. But I've heard most insurance companies do not cover it unless there is a special reason, so most people will need to pay out of pocket, so we buy more economical ones, such as are available from Supplier 19 on our Supplier List. You won't need a prescription to buy one, unless insurance is paying for it.
Since you are actually on O2 therapy, I think your insurance should cover a prescribed oximeter. I suggest starting by giving your doctor the exact description: "ResMed S9 Complete Oximetry Kit" (in the USA this would be ResMed product code 369100). If insurance coverage is denied I suggest appealing the denial. Be sure to get your insurance to pre-authorize it before buying, because it is about $1,400 if buying the ResMed kit.
I use a wrist-mounted Pulse Oximeter, because it can be worn more loosely and more comfortably all night, than one where the whole thing (including batteries and display) clips onto the finger. I have very sensitive skin.
Regarding what would be a good target range for SpO2, perhaps 94% to 96%, according to the article linked below, but when we are asleep, I would think it would be okay to go down to 90% or so. 88%, even if asleep, is widely considered too low.
The following is is a quote from the article linked below.
"… administer oxygen to keep saturations between 94 and 96 percent. No patient needs oxygen saturations above 97 percent and in truth, there is little to no evidence suggesting any clinical benefit of oxygen saturations above 90 percent in any patient."
About the author: Mike McEvoy, PhD, REMT-P, RN, CCRN is the EMS Coordinator for Saratoga County, New York, a paramedic for Clifton Park-Halfmoon Ambulance, and Chief Medical Officer for West Crescent Fire Department. He is a clinical specialist in cardiac surgery and teaches critical care medicine at Albany Medical College. Mike is the EMS editor for Fire Engineering magazine, a popular speaker at EMS, fire, and medical conferences, and lead editor of the Jones & Bartlett textbook, "Critical Care Transport".