Oxygen therapy should never be administered alone in the presence of elevated carbon dioxide (PaCO2) levels in the arterial blood, known as hypercapnia. Oxygen, even with as little as 2 L (liters) per minute, may cause a sudden and rapid rise in PaCO2. This may blunt respiratory drive and produce profound apnea with severe sleepiness, especially when oxygen is administered for sleep at night (Gay & Edmonds, 1995). It is recommended that polio survivors with hypercapnia confer with a sleep and/or pulmonary specialist prior to using oxygen alone for sleep. The more appropriate treatment may be some type of night-time assisted ventilation (Hsu & Staats, 1998) (see Underventilation and Ventilators). When the lungs are expanded enough and CO2 levels fall to normal or near-normal levels, the need for oxygen may be obviated.
Polio survivors, as with the general population, may have other conditions which may be typically treated with oxygen. For example, oxygen therapy may be needed to temporarily supplement normal O2 levels when there is danger of tissue death, such as during an acute heart attack. Oxygen therapy may also be needed when the lungs are impaired, for example, from pneumonia or from emphysema. The decision to use, or not use, oxygen must be based on a thorough evaluation and understanding of the polio survivor’s breathing problems (Hsu & Staats, 1998) (see Underventilation).
Supplemental oxygen may be needed when at higher altitudes by persons with vital capacity (VC) less than 50% of normal. These people may not need supplemental oxygen at lower altitudes, such as at or near sea level.
References
Gay, P., & Edmonds L. (1995). Severe hypercapnia after low-flow oxygen therapy in patients with neuromuscular disease and diaphragmatic dysfunction. Mayo Clinic Proceedings, 70(4), 327-330.
Hsu, A., & Staats, B. (1998). "Postpolio" sequelae and sleep-related disordered breathing. Mayo Clinic Proceedings, 73, 216-224.