ROUNDS·
Respiratory

Oxygen Therapy Devices Explained

Flow rates and approximate FiO2 across common oxygen delivery devices, and when to step up to the next one.

Device Comparison

DeviceFlow rateApprox. FiO2
Nasal cannula1-6 L/min24-44%
Simple face mask5-10 L/min40-60%
Venturi maskVariable24-60% (fixed, precise)
Non-rebreather mask10-15 L/min60-95%
High-flow nasal cannula (HFNC)Up to 60 L/minUp to ~100%, titratable
Bag-valve mask15 L/minUp to 100%

Nasal Cannula

Simple and well-tolerated, but FiO2 is imprecise and varies with the patient's breathing pattern. Good for mild hypoxemia or stable patients.

Masks

The Venturi mask delivers a fixed, precise FiO2 regardless of breathing pattern — useful when controlled oxygen is important (e.g. COPD patients at risk of CO2 retention). The non-rebreather mask delivers high FiO2 via a reservoir bag with one-way valves, used for significant hypoxemia.

HFNC Basics

High-flow nasal cannula delivers heated, humidified oxygen at high flow rates, providing a small amount of positive pressure and washing out dead-space CO2. It's increasingly used as a step between standard oxygen and non-invasive ventilation in conditions like acute hypoxemic respiratory failure.

When to Escalate

Persistent hypoxemia despite an appropriate device, increasing work of breathing, or a rising respiratory rate are signs to escalate — to a higher-FiO2 device, HFNC, non-invasive ventilation, or intubation, depending on the clinical picture and trajectory.

Frequently Asked Questions

Why use a Venturi mask instead of a nasal cannula?

A Venturi mask delivers a fixed, predictable FiO2 regardless of how the patient breathes, which matters most in patients (like some with COPD) where controlled, titratable oxygen is important.

Is HFNC the same as non-invasive ventilation (NIV)?

No — HFNC provides high-flow humidified oxygen with only minimal positive pressure, while NIV (like CPAP or BiPAP) delivers set pressure support through a sealed mask. They're used for different scenarios and severities.

What FiO2 does room air provide for comparison?

Room air is approximately 21% FiO2 — useful as the baseline when comparing how much any given device is increasing inspired oxygen.