Should my daughter have oxygen therapy for 75-77% oxygen sats?

vcanfield - I'm sorry to hear about your daughter's illness. The question of supplemental oxygen is not completely straightforward. There have only been two studies looking at patients with cyanotic congenital heart disease and whether supplemental oxygen leads to any health benefits. Those studies were small but did not show any improvement in survival for patients using oxygen. Generally, patients with cyanotic heart disease are told to use oxygen if they feel better with it. If they are not short of breath at a saturation of 80%, it is not clear if they derive any benefit from being on oxygen.

Part of the question is WHY your daughter is cyanotic. In people with pulmonary arteriovenous malformations, the blood that travels through these malformations goes through the lungs without being oxygenated - we call this an intrapulmonary shunt. This is what causes their saturations to go down. They generally don't see much of an improvement with oxygen because the problem is not one of oxygen/CO2 exchange. If her saturations go from mid-70s to mid 90s with oxygen, that raises the possibility of lung disease rather than low saturations due to a shunt. This might be something that your doctors will want to investigate further.

The argument that her cyanosis is peripheral and not central is a little questionable, but then I don't know the details of her medical history. What that argument suggests is that blood samples from her aorta show normal saturations even though the oximeter shows low saturations. If this is truly the case, then oxygen is probably not necessary. BUT one would not expect this to improve with supplemental oxygen, and she has good reason to have truly low saturations (her pulmonary AV malformations).

The bottom line is, if you daughter feels completely fine, it is not clear that oxygen will make any difference at all other than to make her numbers look better. If she feels limited by fatigue or shortness of breath when she walks or does chores, then oxygen can certainly help. The most important thing is to bring up your concerns with the cardiologist. It is impossible to give really good advice without knowing a person's medical history and doing a physical exam.

Oxygen saturation is not that accurate or a basis of someone who is in respiratory distress. It is not only oxygen that the saturation can pick up. Other gases such as carbon dioxide can also be pick up by this monitor. This not a good indication. I do agree with the peripheral cyanosis part but at the end of the day, it is the patient's comfort that counts. If you think that your daughter needs oxygen then give her the oxygen. I think it is a matter of asserting our rights to the doctor and what we think will benefit out family. If the patient is ok with that oxygen saturation and she is not struggling breathing then there is not need to administer oxygen. I hope you know the reason why she doesn't have a good saturation.

Very simply it means that 90% of your red blood cells are carrying oxygen. While that may not 'sound good' it is also not bad. I don't know your age, weight, if you've just had an infection or major surgery or if you are a smoker. If you are 17 are of normal height and weight and in for a appendectomy, then it's really not good. If you are 75, smoked for 55 years and have pneumonia then damn it's good. It's all about how you look at it. Take care.

You need to keep her 02 sats above 90% so yes she needs oxygen if her sats are in the 70's or 80's.