Oxygen supplementation represents a fundamental therapy in several clinical conditions,
both acute and chronic. Starting from some concepts of respiratory physiopathology, this
paper discusses the approach to a child with respiratory distress and respiratory failure,
focuses on the main signs and symptoms of hypoxia, hypercapnia and increased work of
breathing and explains the methods to assess the severity of the clinical status, highlighting the relevance of the SpO2/FiO2 ratio (peripheral oxygen saturation/inspiratory oxygen fraction). Furthermore, this work aims to summarize the main methods of oxygen delivery, their relative indications, by underlining advantages and possible complications
such as blow-by oxygen, low flow nasal cannula and face mask (simple, Venturi, rebreathing and non-rebreathing). The focus is on two new oxygen delivery devices, High Flow
Nasal Cannula (HFNC) and Continuous Positive Airway Pressure (CPAP), which in recent
years have more and more been used not only in emergency units but also in paediatric
wards.
