Choosing Your Oxygen Delivery Device: Nasal Cannula vs. Portable Oxygen Mask

Inogen

September 19, 2020

woman on couch using a portable oxygen mask

If you or a loved one has just been prescribed oxygen therapy, you probably have a lot of questions. One of the first questions people ask is how will the oxygen therapy be delivered? Whether you need to use a face mask or a nasal cannula for your oxygen delivery, let’s explore why and how you use each one.

Contents hide

1. What Is the Difference Between Nasal Cannulas and Portable Oxygen Masks?

2. What Is the Advantage of Using an Oxygen Mask vs. a Nasal Cannula?

3. How Much Oxygen Can You Use with an Oxygen Mask vs. a Nasal Cannula?

4. When Should You Switch From Nasal Cannula to Oxygen Mask?

5. Adjusting to Your Nasal Cannula or Face Mask

6. References

What Is the Difference Between Nasal Cannulas and Portable Oxygen Masks?

Both a nasal cannula and face mask can be used to deliver supplemental medical oxygen to patients. They attach to the oxygen delivery device—typically an oxygen concentrator or oxygen tank—via tubing to improve oxygen intake. A nasal cannula is a flexible tube with two prongs that go inside the patient’s nostrils, while a face mask is a plastic, rubber or silicone mask that covers the nose and mouth. There are several different kinds of oxygen masks, depending on what the patient needs.^[1]

The most notable difference is that an oxygen mask fits over the patient’s nose and mouth, making it difficult for the patient to talk while receiving oxygen therapy. A nasal cannula, on the other hand, fits directly into the nostrils, allowing the patient to receive oxygen therapy while carrying on a conversation, eating, drinking and more. Nasal cannulas are significantly less obtrusive, so most health care teams opt for a nasal cannula whenever possible.^[1]However, for patients who need a constant, predetermined level of oxygen, a face mask called a Venturi mask is the most common choice. A Venturi mask is able to provide an accurate concentration of oxygen by mixing high-flow oxygen with room air. A Venturi mask is also able to prevent carbon dioxide retention, which can help avoid hypercapnia (elevated carbon dioxide levels) and the suppression of the respiratory drive. ^[2]

What Is the Advantage of Using an Oxygen Mask vs. a Nasal Cannula?

Nasal cannulas offer the advantage of being significantly less intrusive, allowing patients to eat and speak during oxygen therapy. They are also more comfortable to wear since the cannula itself consists of just one small tube and two prongs inside your nostrils.^[1] The tubing can sit over your ears or at the back of the head, so you can adjust the fit in a number of different ways. Some patients can experience nasal dryness, which can generally be resolved with a topical water-based lubricant. ^[2] A face mask, on the other hand, sits over the top of both your nose and mouth with a strap around the back of your head. The mask itself can impede your ability to speak easily, and it is not possible to eat or drink while wearing an oxygen mask. Oxygen masks can also be drying when tightly sealed, and can make coughing difficult as well. Some patients find face masks confining and may feel claustrophobic with the mask on, which can make patients resistant to wearing them. ^[3]

However, in some cases, using a face mask is necessary, even if it is less convenient. For example, if a patient requires a higher concentration of oxygen or a precise concentration, nasal cannulas may be unable to accommodate the prescription. Additionally, patients who are prone to retaining carbon dioxide (hypercapnia) or who have experienced a suppressed respiratory drive may require a face mask called an air-entrainment mask (another name for a Venturi mask) to help ensure they get the correct concentration of oxygen at all times without becoming over-oxygenated.^[4]

How Much Oxygen Can You Use with an Oxygen Mask vs. a Nasal Cannula?

Typically, your doctor will be the one to choose whether you use an oxygen mask or a nasal cannula, since it is generally dependent on your prescribed flow rates and oxygen concentration requirements. That said, each delivery device can provide a different flow rate, or number of liters per minute. There are low-flow options and high-flow options, which have differing abilities to provide controlled amounts of oxygen to the patient. Below, see how much oxygen you can use with each of the most commonly used oxygen delivery devices for oxygen therapy.

Delivery Device	Approx. oxygen delivery	Flow Rate	Comments
Nasal Cannula^[3]	24-40%	1-6 LPM	May be drying to nares above 4L/min.
High Flow Nasal Cannula^[5]	21-100%	up to 60 LPM	Can deliver warmed and up to 100% humidified oxygen
Simple face mask (low-flow system)^[3]	40-60%	6-10 LPM
Non re-breather mask^[3]	60-80%	10-15 LPM	Efficiency depends on how well mask fits and the patient’s respiratory demands
Venturi Mask^[6]	24-60%	up to 15 LPM	Can deliver a more precise level of oxygen but mask must be properly fitting

When Should You Switch From Nasal Cannula to Oxygen Mask?

Your health care providers will decide whether you need to switch from a nasal cannula to an oxygen mask. However, that decision is likely to be based on how much oxygen you need at any given time. Typically, patients who need higher or more precise concentrations of oxygen are more likely to need to use a portable oxygen mask like a Venturi mask. Selection should be based on preventing and treating hypoxemia and preventing complications of hyper-oxygenation. Factors such as how much oxygen is required, the presence of underlying respiratory disease, age, the environment (at home or in the hospital), the presence of an artificial airway, the need for humidity, a tolerance or a compliance problem, or a need for consistent and accurate oxygen must be considered to select the correct oxygen delivery device.^[3]They will also talk to you about what you struggle with when it comes to oxygen therapy, because your comfort does play a part in the success of your oxygen therapy. Your healthcare providers will make any decisions and adjustments to your oxygen delivery device based on information about your overall respiratory health.

Adjusting to Your Nasal Cannula or Face Mask

The fact is that oxygen therapy, and the required oxygen equipment, does take a little getting used to at first. Whether you are getting accustomed to wearing a nasal cannula or a face mask, there will be times you experience frustration as you get used to wearing them comfortably throughout the day and navigating around the tubing. Optimizing outcomes often depends on selecting the correct oxygen administration device.^[2]

If you have questions about your oxygen delivery device, or are interested in exploring a different kind of face mask or nasal cannula, talk to your doctor today. The right oxygen delivery device is essential for helping to make your oxygen therapy as successful as possible.

References

Heitz D. Nasal Cannulas and Face Masks. Healthline, Healthline Media, 8 July 2017, www.healthline.com/health/nasal-cannulas-and-face-masks.
Oxygen Administration: What Is the Best Choice?, RT Magazine, MEDQOR Media, 12 Oct. 2015, www.rtmagazine.com/products-treatment/monitoring- treatment/therapy-devices/oxygen-administration-best-choice/.
Doyle GR and McCutcheon JA, 5.5 Oxygen Therapy Systems. Clinical Procedures for Safer Patient Care, BCcampus, 23 Nov. 2015, 5.5 Oxygen Therapy Systems – Clinical Procedures for Safer Patient Care (opentextbc.ca)
King JE. How Do I Choose a Supplemental Oxygen Delivery Device? : Nursing2020. Nursing, LWW Journals, Dec. 2003, How do I choose a supplemental oxygen delivery device? : Nursing2022 (lww.com)
Sharma S. High Flow Nasal Cannula. StatPearls [Internet]., U.S. National Library of Medicine, 25 Feb. 2020, www.ncbi.nlm.nih.gov/books/NBK526071/
Oxygen – Delivery Devices. Oxford Medical Education, Oxford Medical Education, 18 Apr. 2016, Oxygen – delivery devices – Oxford Medical Education