Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Oxygen therapy has a long-standing role in the management of acute exacerbations of congestive heart failure (CHF), particularly when associated with hypoxemia (low blood oxygen levels). Supplemental oxygen is administered to improve tissue oxygenation, relieve symptoms such as breathlessness, and reduce the workload on the heart. The scientific basis lies in its ability to increase arterial oxygen content, thereby ensuring adequate oxygen delivery to vital organs during decompensated heart failure episodes. Several clinical guidelines, such as those from the American Heart Association and European Society of Cardiology, recommend oxygen supplementation in CHF patients who are hypoxic (e.g., SpO₂ <90%).

However, routine or indiscriminate use of oxygen in all CHF patients—especially those who are not hypoxemic—lacks robust support. Some studies suggest that unnecessary oxygen administration could even be harmful by causing vasoconstriction or reducing cardiac output due to increased systemic vascular resistance. The evidence base is thus moderate: while there is clear benefit in hypoxemic patients, the utility in normoxic CHF patients is not substantiated by strong clinical trials. Overall, the use of oxygen in CHF is scientifically validated for hypoxemic individuals, earning a moderate evidence rating.

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