Oxygen toxicity

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  • The harmful effects of breathing oxygen at higher partial pressures than normal
    • Partial pressure of O2 at sea level = 0.21 ATM
  • Toxicity based on both time of exposure and partial pressure of oxygen
    • Generally, FiO2 of 40% or less (0.40 ATM) can be tolerated indefinitely[1]
    • Most common in hyperbaric oxygen therapy, scuba divers and prolonged administration of normobaric supplemental oxygen
    • Pulmonary toxicity occurs sooner and at lower partial pressures than CNS toxicity[1], however there is no predictable pattern or sequence of symptoms for CNS toxicity (initial symptom may be seizure/coma)[2]

Clinical Features


Central nervous system


  • Retinopathy of prematurity (retrolental fibroplasia) - seen in premature infants
  • Hyperoxic myopia - seen in adults exposed to repeated toxic levels of oxygen[4]
    • Resolves spontaneously over several weeks

Differential Diagnosis

Diving Emergencies


  • Generally clinical


  • Lower inhaled partial pressure of oxygen to as low as tolerated while maintaining tissue perfusion[5]


  • Admit

See Also

External Links


  1. 1.0 1.1 Hedley-Whyte J. Pulmonary Oxygen Toxicity: Investigation and Mentoring. The Ulster Medical Journal. 2008;77(1):39-42.
  2. 2.0 2.1 Bitterman H. Bench-to-bedside review: Oxygen as a drug. Critical Care. 2009;13(1):205. doi:10.1186/cc7151.
  3. Thomson L, Paton J. Oxygen toxicity. Paediatr Respir Rev. 2014 Jun;15(2):120-3.
  4. Anderson B, Farmer JC. Hyperoxic myopia. Transactions of the American Ophthalmological Society. 1978;76:116-124.
  5. Deutschman, C. S., & Neligan, P. J. (2010). Evidence-based practice of critical care. Philadelphia, PA: Saunders/Elsevier.