Introduction
Pulmonary artery hypertension is a condition in which the blood pressure in the lungs is high. It affects the arteries in the lungs and the heart and reduces the heart’s efficiency. Oxygen therapy helps reduce the stress created by pulmonary hypertension and increases the amount of oxygen in the blood. It also helps relax the arteries and reduces the pressure in them. According to the guidelines, oxygen therapy is recommended in the treatment of pulmonary artery hypertension only if the patients develop hypoxemia (low oxygen level in the blood), but a new evidence-based study suggests that oxygen offers therapeutic benefits for all patients.
What Is Pulmonary Arterial Hypertension?
Pulmonary arterial hypertension is when the blood pressure is high in the pulmonary arteries (arteries of the lungs) that transport oxygen-poor blood from the heart to the lungs. It can be due to various causes, but it usually occurs as a complication of lung disease or heart disease. In addition, several other diseases and environmental factors can increase the risk for pulmonary artery hypertension. Pulmonary arterial hypertension can affect adults at any age of life. Individuals with conditions like aortic valve disease, mitral valve disease, scleroderma (hardening of the skin and connective tissue), and sickle cell disease (a disorder that causes the breakdown of red blood cells) are at a higher risk for developing pulmonary hypertension.
The increased pressure in the pulmonary arteries requires treatment because it disrupts the blood flow through the heart and the lungs. An increase in pressure causes the narrowing of the arteries and disrupts the blood flow. As a result, the heat pumps harder to transport oxygen-poor blood to the lungs. This stress and increased workload can result in heart failure over a period of time.
What Are the Symptoms of Pulmonary Arterial Hypertension?
The initial symptom of pulmonary arterial hypertension is dyspnea (shortness of breath) during daily activities like climbing stairs or during exercises. The following symptoms may occur later when hypertension progresses or worsens. It includes:
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Cyanosis (bluish discoloration of the skin).
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Chest pain.
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Fatigue.
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Dizziness.
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Loss of appetite.
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Increased heartbeat.
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Edema (swelling) in the ankles and legs
What Are the Complications of Pulmonary Arterial Hypertension?
Pulmonary arterial hypertension can cause various complications, including arrhythmias (abnormal heartbeat), anemia (reduced red blood cells), blood clots in the pulmonary arteries, and pericardial effusion (accumulation of fluid in the pericardial covering of the heart). If left untreated, pulmonary arterial hypertension can increase the workload of the heart and eventually result in cardiac failure. The lungs receive blood when the heart's right ventricle (lower chamber) pumps. Increased blood pressure in the pulmonary arteries increases the workload and forces the heart to work harder to transport oxygen-poor blood to the lungs for oxygenation. This increased workload increases the size of the right ventricle over a period of time, resulting in right ventricular hypertrophy, which further leads to right heart failure. Right heart failure causes various complications in the body and disrupts the normal functioning of the organs and systems.
Why Should Pulmonary Arterial Hypertension Be Treated?
Pulmonary arterial hypertension progresses and worsens over time. If left untreated, pulmonary arterial hypertension results in right heart failure and death. Treatment does not cure hypertension but improves the chances of survival for many years. The treatment options depend on the type of hypertension and other underlying medical conditions. The treatment options include medications, surgical techniques, and oxygen therapy.
What Is Oxygen Therapy in Pulmonary Arterial Hypertension?
In individuals with pulmonary arterial hypertension, the heart and lungs work harder to meet the oxygen requirement. In this condition, oxygen levels in the blood are reduced at rest and during exercise. This decrease in oxygen causes shortness of breath and tiredness. Oxygen therapy helps increase the blood oxygen level and reduces these symptoms. Oxygen is a potent vasodilator, which helps relax the pulmonary arteries and reduces the pressure in them.
How Does Oxygen Treat Pulmonary Arterial Hypertension?
Oxygen therapy with supplemental oxygen ensures adequate oxygen supply in pulmonary arterial hypertension, where the amount of oxygen is limited. It helps reduce the stress on the heart and other organs created by pulmonary arterial hypertension. When oxygen is inhaled into the lungs, it dissolves in the blood and is delivered to the organs and tissues. In pulmonary arterial hypertension, the lungs cannot deliver sufficient oxygen to the blood. Oxygen therapy improves oxygenation and reduces shortness of breath. The oxygen requirement varies with the person; in which some individuals may require it for the long term.
What Are the Types of Oxygen Therapy?
Oxygen therapy can be administered in several ways. If oxygen therapy is required for a short period to relieve breathlessness, oxygen cylinders are prescribed. Oxygen concentrator machines are prescribed for individuals who require oxygen for a significant amount of time, especially during sleep. The following oxygen delivery systems are used depending on the requirement.
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Oxygen Concentrator:
An oxygen concentrator is a machine that runs on electricity. This machine filters oxygen from the air in the room and delivers the filtered oxygen via a plastic tube to a mask or through a cannula (soft tubes) to the nose. These concentrators are usually recommended for long-term therapy.
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Oxygen Cylinders:
An oxygen cylinder delivers oxygen through a mask or cannulae in the nose. Oxygen cylinders can help overcome short periods of breathlessness. Portable cylinders are used if oxygen therapy is required outside the home.
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Portable Oxygen Cylinders:
Portable oxygen cylinders are required during travel or outside the home. Portable oxygen cylinders can hold under two hours of oxygen at two liters per minute. Semiportable cylinders are also available, but they are heavier and are difficult to carry out of the house.
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Portable Oxygen Concentrators:
Portable oxygen concentrators work on a rechargeable battery or in-car charger and can run for a number of hours. However, portable oxygen concentrators are not available on prescription and are purchased privately.
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Oxygen Conservers:
Oxygen cylinders supply a constant flow of oxygen once turned on. However, oxygen conservers change the oxygen flow according to the breath of the person. This helps eliminate wastage and conserves oxygen.
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Oxygen Humidifiers:
Oxygen humidifiers are used if oxygen flow rates higher than four liters per minute are required. Humidifiers add water vapor to the oxygen that is inhaled and prevent the drying out of the nasal passages due to oxygen inhalation.
Conclusion:
Pulmonary arterial hypertension is a condition that affects the arteries in the lungs and the heart and reduces the heart’s efficiency. Oxygen therapy is given to reduce the stress on the heart and improve oxygenation. Oxygen therapy is prescribed as a supplemental therapy and not as a replacement for medications. It improves the symptoms of pulmonary arterial hypertension and reduces hospital readmissions.
