Risks from Breathing Elevated Oxygen

INTRODUCTION: Effects of breathing gas with elevated oxygen partial pressure (Po₂) and/or elevated inspired oxygen fraction (F_Io₂) at sea level or higher is discussed. High F_Io₂ is associated with absorption problems in the lungs, middle ear, and paranasal sinuses, particularly if F_Io₂ > 80% and small airways, Eustachian tubes, or sinus passages are blocked. Absorption becomes faster as cabin altitude increases. Pulmonary oxygen toxicity and direct oxidative injuries, related to elevated Po₂, are improbable in flight; no pulmonary oxygen toxicity has been found when Po₂ < 55 kPa [418 Torr; 100% O₂ higher than 15,000 ft (4570 m)]. Symptoms with Po₂ of 75 kPa [520 Torr; 100% O₂ at 10,000 ft (3050 m)] were reported after 24 h and the earliest signs at Po₂ of 100 kPa (760 Torr, 100% O₂ at sea level) occurred after 6 h. However, treatment for decompression sickness entails a risk of pulmonary oxygen toxicity. Elevated Po₂ also constricts blood vessels, changes blood pressure control, and reduces the response to low blood sugar. With healthy lungs, gas transport and oxygen delivery are not improved by increasing Po₂. Near zero humidity of the breathing gas in which oxygen is delivered may predispose susceptible individuals to bronchoconstriction.Shykoff BE, Lee RL.