Oxygen therapy is a treatment that provides you with extra oxygen. Oxygen is a gas that your body needs to function. Normally, your lungs absorb oxygen from the air you breathe. But some conditions can prevent you from getting enough oxygen.

You may need oxygen if you have

• COPD (chronic obstructive pulmonary disease)
• Pneumonia
• A severe asthma attack
• Late-stage heart failure
• Cystic fibrosis
• Sleep apnea

The oxygen comes through nasal prongs, a mask, or a breathing tube. If you have a chronic problem, you may have a portable oxygen tank or a machine in your home.

A different kind of oxygen therapy is called hyperbaric oxygen therapy. It uses oxygen at high pressure to treat wounds and serious infections.

Oxygen is a gas that your body needs to work properly. Your cells need oxygen to make energy. Your lungs absorb oxygen from the air you breathe. The oxygen enters your blood from your lungs and travels to your organs and body tissues.

Certain medical conditions can cause your blood oxygen levels to be too low. Low blood oxygen may make you feel short of breath, tired, or confused. It can also damage your body. Oxygen therapy can help you get more oxygen.

Oxygen therapy is a treatment that delivers oxygen gas for you to breathe.

Overview

You can receive oxygen therapy from tubes resting in your nose, a face mask, or a tube placed in your trachea, or windpipe. This treatment increases the amount of oxygen your lungs receive and deliver to your blood. Oxygen therapy may be prescribed for you when you have a condition that causes your blood oxygen levels to be too low. Low blood oxygen may make you feel short of breath, tired, or confused, and can damage your body.

Oxygen therapy can be given for a short or long period of time in the hospital, another medical setting, or at home. Oxygen is stored as a gas or liquid in special tanks. These tanks can be delivered to your home and contain a certain amount of oxygen that will require refills. Another device for use at home is an oxygen concentrator, which pulls oxygen out of the air for immediate use. Because oxygen concentrators do not require refills, they won’t run out of oxygen. Portable tanks and oxygen concentrators may make it easier for you to move around while using your therapy.

Oxygen poses a fire risk, so you should never smoke or use flammable materials when using oxygen. You may experience side effects from this treatment, such as a dry or bloody nose, tiredness, and morning headaches. Oxygen therapy is generally safe.

Your doctor may recommend oxygen therapy if you have a low blood oxygen level. Normally, your lungs absorb oxygen from the air and transfer it into your bloodstream.

Some acute (short-term) and chronic (ongoing) diseases and conditions can prevent you from getting enough oxygen.

Acute Diseases and Conditions

You may receive oxygen therapy if you're in the hospital for a serious condition that prevents you from getting enough oxygen. Once you've recovered from the condition, the oxygen will likely be stopped.

Some diseases and conditions that may require short-term oxygen therapy are:

• Severe pneumonia. Pneumonia is an infection in one or both of the lungs. If severe, the infection causes your lungs' air sacs to become very inflamed. This prevents the air sacs from moving enough oxygen into your blood.
• Severe asthma attack. Asthma is a lung disease that inflames and narrows the airways. Most people who have asthma, including many children, can safely manage their symptoms. But if you have a severe asthma attack, you may need hospital care that includes oxygen therapy.
• Respiratory distress syndrome (RDS) or bronchopulmonary dysplasia (BPD) in premature babies. Premature babies may develop one or both of these serious lung conditions. As part of their treatment, they may receive extra oxygen through a nasal continuous positive airway pressure (NCPAP) machine or a ventilator (VEN-til-a-tor), or through a tube in the nose.

Chronic Diseases and Conditions

Long-term home oxygen therapy might be used to treat some diseases and conditions, such as:

• COPD (chronic obstructive pulmonary disease). This is a progressive disease in which damage to the air sacs prevents them from moving enough oxygen into the bloodstream. "Progressive" means the disease gets worse over time.
• Late-stage heart failure. This is a condition in which the heart can't pump enough oxygen-rich blood to meet the body's needs.
• Cystic fibrosis (CF). CF is an inherited disease of the secretory glands, including the glands that make mucus and sweat. People who have CF have thick, sticky mucus that collects in their airways. The mucus makes it easy for bacteria to grow. This leads to repeated, serious lung infections. Over time, these infections can severely damage the lungs.
• Sleep-related breathing disorders that lead to low levels of oxygen in the blood during sleep, such as sleep apnea.

Oxygen therapy provides you with extra oxygen, a gas that your body needs to work well. Oxygen comes in different forms and can be delivered to your lungs in several ways.

Oxygen Therapy Systems

Oxygen is supplied in three forms: as compressed gas, as liquid, or as a concentrated form taken from the air.

Compressed oxygen gas is stored under pressure in metal cylinders. The cylinders come in many sizes. Some of the cylinders are small enough to carry around. You can put one on a small wheeled cart or in a shoulder bag or backpack.

Liquid oxygen is very cold. When released from its container, the liquid becomes gas. Liquid oxygen is delivered to your home in a large container. From this container, smaller, portable units can be filled.

The advantage of liquid oxygen is that the storage units need less space than compressed or concentrated oxygen. However, liquid oxygen costs more than the other forms of oxygen. Also, it evaporates easily, so it doesn't last for a long time.

Oxygen concentrators filter out other gases in the air and store only oxygen. Oxygen concentrators come in several sizes, including portable units.

Oxygen concentrators cost less than the other oxygen therapy systems. One reason is because they don't require oxygen refills. However, oxygen concentrators are powered by electricity. Thus, you'll need a backup supply of oxygen in case of a power outage.

Delivery Devices

Most often, oxygen is given through a nasal cannula. A nasal cannula consists of two small plastic tubes, or prongs, that are placed in both nostrils.

To help hold the cannula in place, you can put the longer ends of it over your ears or attach them to a special kind of eyeglass frame that helps hide the tubing. The tubing then comes around the back of your ears and under your chin, where it joins together. From there, it's attached to the tube from the oxygen container.

Nasal Cannula and Portable Oxygen Container

You might use a face mask instead of a nasal cannula. The mask fits over your mouth and nose. This method mainly is used if you need a high flow rate of oxygen or if your nose is clogged from a cold.

The face mask is held in place with a strap that goes around your head or with tubes that fit around your ears. The oxygen is delivered through a tube that attaches to the front of the mask.

Oxygen also can be delivered through a small tube inserted into your windpipe through the front of your neck. Your doctor will use a needle or small incision (cut) to place the tube. Oxygen delivered this way is called transtracheal oxygen therapy.

If you're getting transtracheal oxygen therapy, you'll need to have a humidifier attached to your oxygen system. This is because the oxygen doesn't pass through your nose or mouth like it does with the other delivery systems. A humidifier adds moisture to the oxygen and prevents your airways from getting too dry.

Oxygen also can be delivered through machines that support breathing, such as CPAP (continuous positive airway pressure) devices or ventilators.

Hyperbaric oxygen therapy (HBOT) is well known for treating scuba and deep-sea divers affected by the rapid change in pressure around them. But did you know that HBOT is also used to treat a variety of other health problems, including carbon monoxide poisoning and diabetic foot ulcers?

If you are considering the use of a HBOT device for yourself or a loved one, be aware that some claims of what it can do are unproven. For example, HBOT devices are not proven to cure cancer, Lyme disease, autism or Alzheimer’s disease. The U.S. Food and Drug Administration recommends you check with your health care provider before using a HBOT device to make sure you are pursuing the most appropriate care. If your health care provider recommends HBOT, the FDA advises that you go to a hospital or facility that has been inspected and is properly accredited by the Undersea and Hyperbaric Medical Society.

Hyperbaric oxygen therapy and the FDA’s role

Our body’s tissues need oxygen to function. The air we breathe is 21% oxygen.

HBOT involves breathing 100% (pure) oxygen while in a special space called a hyperbaric chamber. The air pressure inside is raised to a level that is higher than normal air pressure.

The increased air pressure in the chamber helps the lungs collect more oxygen. Getting more oxygen to the tissues that need it can help the body heal and fight certain infections. However, too much oxygen can cause damage to the body.

The FDA regulates both the oxygen used in HBOT and the hyperbaric chambers, which are generally a tube large enough to hold one person or a room that can accommodate more than one person.

Conditions for which hyperbaric chambers are cleared for marketing by the FDA

FDA clearance of a medical device includes a determination that the device has the same intended use as, and is as safe and effective as, another legally U.S.-marketed device of that type. As of July 2021, the FDA has cleared hyperbaric chambers for the following disorders:

• Air and gas bubbles in blood vessels
• Anemia (severe anemia when blood transfusions cannot be used)
• Burns (severe and large burns treated at a specialized burn center)
• Carbon monoxide poisoning
• Crush injury
• Decompression sickness (diving risk)
• Gas gangrene
• Hearing loss (complete hearing loss that occurs suddenly and without any known cause)
• Infection of the skin and bone (severe)
• Radiation injury
• Skin graft flap at risk of tissue death
• Vision loss (when sudden and painless in one eye due to blockage of blood flow)
• Wounds (non-healing, diabetic foot ulcers)

HBOT is being studied for other conditions, including COVID-19. However, at this time, the FDA has not cleared or authorized the use of any HBOT device to treat COVID-19 or any conditions beyond those listed above. The website, clinicaltrials.gov, has more information on HBOT clinical trials for COVID-19 and other conditions.

Risks of hyperbaric oxygen therapy

When HBOT chambers are used for indications cleared by the FDA, HBOT is generally safe, and serious complications are rare.

Because of the increased pressure and increased concentration of the oxygen during HBOT, potential risks include:

• Ear and sinus pain
• Middle ear injuries, including tympanic membrane rupture
• Temporary vision changes
• Lung collapse (rare)

High concentrations of oxygen also pose the risk of fire, which is one reason why the FDA recommends treatment at an accredited facility. Explosions and fires have occurred in HBOT chambers that have not been reviewed by the FDA and are located at unaccredited facilities.

Other hyperbaric devices

The FDA has also cleared a large, zippered bag that is intended to treat altitude sickness only.

These zippered chambers for treating altitude sickness provide pressure but do not attach to oxygen tanks. The FDA has not cleared these bags for use with oxygen tanks or oxygen concentrators. However, the FDA is aware of instances in which people used these bags to create homemade HBOT devices, which can pose the risk of fire and suffocation.

To survive, we need oxygen going from our lungs to the cells in our body. Sometimes the amount of oxygen in our blood can fall below normal levels. Asthma, lung cancer, chronic obstructive pulmonary disease (COPD), the flu, and COVID-19 are some of the health issues that may cause oxygen levels to drop. When the levels are too low, we may need to take extra oxygen, known as oxygen therapy.

One way to get extra oxygen into the body is by using an oxygen concentrator. Oxygen concentrators are medical devices required to be sold and used only with a prescription.

You should not to use an oxygen concentrator at home unless it has been prescribed by a health care provider. Giving yourself oxygen without talking to a doctor first may do more harm than good. You may end up taking too much or too little oxygen. Deciding to use an oxygen concentrator without a prescription can lead to serious health problems such as oxygen toxicity caused by receiving too much oxygen. It can also lead to a delay in receiving treatment for serious conditions like COVID-19.

Even though oxygen makes up about 21 percent of the air around us, breathing high concentrations of oxygen may damage your lungs. On the other hand, not getting enough oxygen into the blood, a condition called hypoxia, could damage the heart, brain, and other organs.

Find out if you really need oxygen therapy by checking with your health care provider. If you do, your health care provider can determine how much oxygen you should take and for how long.

What do I need to know about oxygen concentrators?

Oxygen concentrators take in air from the room and filter out nitrogen. The process provides the higher amounts of oxygen needed for oxygen therapy.

Concentrators may be large and stationary or small and portable. Concentrators are different than tanks or other containers supplying oxygen because they use electrical pumps to concentrate the continuous supply of oxygen that comes from the surrounding air.

You may have seen oxygen concentrators for sale online without a prescription. At this time, the FDA has not approved or cleared any oxygen concentrators to be sold or used without a prescription.

When using an oxygen concentrator:

• Do not use the concentrator, or any oxygen product, near an open flame or while smoking
• Place the concentrator in an open space to reduce chances of device failure from overheating
• Do not block any vents on the concentrator since it may impact device performance
• Periodically check your device for any alarms to make sure you are getting enough oxygen.

If you are prescribed an oxygen concentrator for chronic health problems and have changes in your breathing or oxygen levels, or have symptoms of COVID-19, call your health care provider. Do not make changes to the oxygen levels on your own.

How are my oxygen levels monitored?

Oxygen levels are monitored with a small device called a pulse oximeter, or pulse ox.

Pulse oximeters are placed on a finger, toe or forehead and use beams of light to indirectly measure the level of oxygen in the blood.

What do I need to know about pulse oximeters?

As with any device, there is always a risk of an inaccurate reading. If you are using a pulse oximeter to monitor your oxygen levels and are concerned about the reading, contact a health care provider. And do not rely only on a pulse oximeter. It is important to keep track of your symptoms, or how you feel. Contact a doctor if your symptoms are serious or get worse.

When using a pulse oximeter:

• Sit still and do not move the part of your body where the pulse oximeter is
• Do not use the device on your hands when your hands are cold
• Remove all fingernail polish if using the device on your hands.

If you experienced a problem or injury that you think may be related to a pulse oximeter or oxygen concentrator, you can voluntarily report it through the FDA’s MedWatch program.

During an emergency—such as a serious accident, possible heart attack, or other life-threatening event—you might be started on oxygen therapy right away.

Otherwise, your doctor will decide whether you need oxygen therapy based on test results. An arterial blood gas test and a pulse oximetry test can measure the amount of oxygen in your blood.

For an arterial blood gas test, a small needle is inserted into an artery, usually in your wrist. A sample of blood is taken from the artery. The sample is then sent to a laboratory, where its oxygen level is measured.

For a pulse oximetry test, a small sensor is attached to your fingertip or toe. The sensor uses light to estimate how much oxygen is in your blood.

If the tests show that your blood oxygen level is low, your doctor may prescribe oxygen therapy. In the prescription, your doctor will include the number of liters of oxygen per minute that you need (oxygen flow rate). He or she also will include how often you need to use the oxygen (frequency of use).

Frequency of use includes when and for how long you should use the oxygen. Depending on your condition and blood oxygen level, you may need oxygen only at certain times, such as during sleep or while exercising.

If your doctor prescribes home oxygen therapy, he or she can help you find a home equipment provider. The provider will give you the equipment and other supplies you need.

During an emergency—such as a serious accident, possible heart attack, or other life-threatening event—you might be started on oxygen therapy right away.

While you're in the hospital, your doctor will check on you to make sure you're getting the right amount of oxygen. Nurses or respiratory therapists also may assist with the oxygen therapy.

If you're having oxygen therapy at home, a home equipment provider will help you set up the oxygen therapy equipment at your house.

Trained staff will show you how to use and take care of the equipment. They'll supply the oxygen and teach you how to safely handle it.

Because oxygen poses a fire risk, you'll need to take certain safety steps. Oxygen isn't explosive, but it can worsen a fire. In the presence of oxygen, a small fire can quickly get out of control. Also, the cylinder that compressed oxygen gas comes in can explode if it's exposed to heat.

Your home equipment provider will give you a complete list of safety steps that you'll need to follow at home and in public. For example, while on oxygen, you should:

• Never smoke or be around people who are smoking
• Never use paint thinners, cleaning fluids, gasoline, aerosol sprays, and other flammable materials
• Stay at least 5 feet away from gas stoves, candles, and other heat sources

When you're not using the oxygen, keep it in a large, airy room. Never store compressed oxygen gas cylinders and liquid oxygen containers in small, enclosed places, such as in closets, behind curtains, or under clothes.

Oxygen containers let off small amounts of oxygen. These small amounts can build up to harmful levels if they're allowed to escape into small spaces.

Oxygen therapy can cause complications and side effects. These problems might include a dry or bloody nose, skin irritation from the nasal cannula or face mask, fatigue (tiredness), and morning headaches.

If these problems persist, tell your doctor and home equipment provider. Depending on the problem, your doctor may need to change your oxygen flow rate or the length of time you're using the oxygen.

If nose dryness is a problem, your doctor may recommend a nasal spray or have a humidifier added to your oxygen equipment.

If you have an uncomfortable nasal cannula or face mask, your home equipment provider can help you find a device that fits better. Your provider also can recommend over-the-counter gels and devices that are designed to lessen skin irritation.

Complications from transtracheal oxygen therapy can be more serious. With this type of oxygen therapy, oxygen is delivered through a tube inserted into your windpipe through the front of your neck.

With transtracheal oxygen therapy:

• Mucus balls might develop on the tube inside the windpipe. Mucus balls tend to form as a result of the oxygen drying out the airways. Mucus balls can cause coughing and clog the windpipe or tube.
• Problems with the tube slipping or breaking.
• Infection.
• Injury to the lining of the windpipe.

Proper medical care and correct handling of the tube and other supplies may reduce the risk of complications.

Other Risks

In certain people, oxygen therapy may suppress the drive to breathe, affecting how well the respiratory system works. This is managed by adjusting the oxygen flow rate.

Oxygen poses a fire risk, so you'll need to take certain safety steps. Oxygen itself isn't explosive, but it can worsen a fire. In the presence of oxygen, a small fire can quickly get out of control. Also, the cylinder that compressed oxygen gas comes in might explode if exposed to heat.

Your home equipment provider will give you a complete list of safety steps you'll need to take at home and when out in public.

For example, when you're not using the oxygen, keep it in an airy room. Never store compressed oxygen gas cylinders and liquid oxygen containers in small, enclosed places, such as in closets, behind curtains, or under clothes.

Oxygen containers let off small amounts of oxygen. These small amounts can build up to harmful levels if they're allowed to escape into small spaces.

Oxygen therapy helps many people function better and be more active. It also may help:

• Decrease shortness of breath and fatigue (tiredness)
• Improve sleep in some people who have sleep-related breathing disorders
• Increase the lifespan of some people who have COPD (chronic obstructive pulmonary disease)

Although you may need oxygen therapy continuously or for long periods, it doesn't have to limit your daily routine. Portable oxygen units can make it easier for you to move around and do many daily activities. Talk with your doctor if you have questions about whether certain activities are safe for you.

Portable oxygen units also can make it easier for you to travel. Often, the rules for traveling with oxygen vary depending on the transportation carrier (for example, the airline or bus company). If you need oxygen while traveling, plan in advance. Contact your transportation carrier to find out their specific rules.

Also, talk with your doctor and home equipment provider if you're planning to travel. They can help you plan for your oxygen needs and fill out any required medical forms.

Ongoing Care

To make sure you're getting the full benefits of oxygen therapy, visit your doctor regularly. Your doctor can check your progress and adjust your oxygen therapy as needed.

Never change the amount of oxygen you're taking or adjust the flow rate of your oxygen on your own. Discuss any problems or side effects with your doctor first. He or she may recommend adjusting your treatment.

Talk with your doctor about when you should contact him or her or seek emergency medical care. Your doctor can advise you about what to do if you have:

• Increased shortness of breath, wheezing, or other changes from your usual breathing.
• Fever, increased mucus production, or other symptoms of an infection.
• A blue tint to your lips or fingernails. This is a sign that your body isn't getting enough oxygen.
• Confusion, restlessness, or more anxiety than usual.

During an emergency, go to your nearest hospital emergency room or call 9–1–1. You might want to wear a medical ID bracelet or necklace to alert others to your medical needs.