Overview of oxygen delivery devices

Contributors: Michael Lipnick, MD, Cornelius Sendagire, MMed, Rich Kallet, MS, RRT, FAARC, Rich Branson, MS, RRT, Rebecca Silvers, BSN, MSN, DnP

Date last updated: Feb 28, 2023

Created by the OpenCriticalCare.org Project for the WHO SARI Toolkit, 2021 CC SA-BY-NC

Estimating oxygen concentration delivered by low flow O2 delivery devices

Wall Chart for Oxygen Escalation (Adults)

Download the full infographic here.

Wall Chart for Oxygen Escalation (Pediatrics)

Download the full infographic here.

Wall Chart for Oxygen Escalation (Neonates)

Download the full infographic here.

Nasal cannula or nasal prongs for oxygen delivery

Pediatric and neonatal nasal cannula

For neonates, low flow nasal cannula may be administered at flows 0-1 LPM with effectively minimal or no positive pressure (<1 cmH20), or may be administered at flows of 0-3 LPM with a blender. The blender allows delivery of controlled, lower FiO2 (e.g. 0.25 – 0.4), and the higher flows may provide some positive pressure (0-3 cmH20).

Consider the following sizes and ranges for oxygen delivery via nasal cannula in neonates and pediatrics:

O2 flow (L/min)
Cannula Size

WHO Respiratory equipment training video – How to select the right equipment for your health facility

Simple face mask
Hudson High flow nasal oxygen cannula setup with active heated humidification for pediatrics

Bubble CPAP devices may come in many difference configurations such as that show above, or a clinician improvised version show below. Pressure is determined by flow and the depth of the expiratory limb in the water chamber.

Titration of bubble CPAP includes:

  1. Start at a flow rate of 5 L/min
  2. Immerse the expiratory limb in the water chamber, to a depth in cm that equals the desired CPAP pressure (i.e. cmH2O)
  3. Look for bubbles and titrate toward 10 L/min if needed to generate bubbles
Facemask, non rebreather mask for oxygen delivery showing one-way exhaust ports
Adult patient with facemask with reservoir receiving oxygen therapy
Air entrainment (venturi) mask with color coded adapters for oxygen delivery
High flow nasal cannula oxygen system with wall supply oxygen, blender and active heated humidification system

High flow nasal cannula fitting & titration for neonates and pediatrics

Appropriate sizing of high flow nasal cannula is critical, especially for neonates and pediatrics. The HFNC prongs should occupy no more than 50% of the diameter of the nares to allow for flow around the cannual and to avoid excess pressure delivery.

Flow titration by weight:

  • 0-10 kg         2L/kg/minute flow            (max 8 LPM)
  • 10-20 kg       1L/kg/minute flow
  • 20-40 kg       0.5-1L/kg/minute flow    (max 30 LPM)
  • >40 kg           0.5-1L/kg/minute flow    (max 60 LPM)

How to setup a high flow nasal cannula device

Wall continuous positive airway pressure (CPASP) or expiratory positive airway pressure (EPAP) device facemask with tubing for oxygen delivery

Continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP/NIPPV), and expiratory positive airway pressure (EPAP) waveforms comparison

Evidence for non-invasive ventilation in adults

Multiple patient interfaces can be utilized to delivery NIV/NIPPV/BIPAP or CPAP.

How to setup CPAP and BIPAP

by WHO, 2021

Mechanical ventilator with wall supply oxygen and active heated humidification system

Do you have additional questions?

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