Fifty years ago the air that we breathed was clean and pure and free of environmental/domestic/industrial pollution. While we agree that we have ‘developed’ in every walk of life this cannot be true about the poor atmospheric air quality which is been further aggravated by industrialisation and contamination of natural resources – deforestation – lowering of water table due to excessive and deep extraction of water for use. The sum and substance is that the air that we breathe today has excessive pollutants, more carbon dioxide and other noxious gases and less oxygen.
There are clear battery of medical conditions that can be influenced by pollution – atmospheric – self induced like smoking – poorly ventilated homes and burning of fossil fuel for daily needs in cramped – under ventilated domestic spaces. The respiratory disease that is caused by smoking is called Chronic Obstructive Lung Disease (COPD) - which is essentially the effect of noxious particles and gases that permanently damage the airways and the distal gas exchange apparatus.
This obviously leads to symptoms like breathlessness cough recurrent respiratory infections that are basically caused by a background of relative lack of oxygen. So, one of the prime approach to treatment of severe COPD is to supply oxygen through a cylinder or an oxygen concentrator. Oxygen can also be used as a drug in any medical condition where there is relative or absolute lack of oxygen – in conditions like acute severe asthma, COPD, respiratory failure from any cause or interstitial lung disease. These are conditions where oxygen is used as supplementary therapy usually as Low Flow Oxygen.
There is also a condition specific to Southeast Asia – non-smoking COPD generally found in females with prolonged exposure to biomass fuels produced by burning of organic fuels like wood dung etc which produces chronic indoor air pollution which is essentially responsible for non-smoking COPD.
The other common disease where oxygen is used as supplementary therapy is interstitial lung disease where there is a fibrosis and destruction of lung architecture which may be caused by known diseases like rheumatoid arthritis – drug induced and a disease called idiopathic pulmonary fibrosis where the cause is unknown. This is another classic disease where supplementary oxygen therapy is extremely useful.
In conclusion, oxygen is a drug that has a specific indication in conditions that have an established diagnosis and needs to be monitored carefully for effective outcomes.
Dr. Prasanna Kumar Thomas, Pulmonologist, Fortis Malar Hospital