From mysterious natural element to an often-used medical treatment, oxygen has a storied past:


Working independently in 1774, Joseph Priestley heated mercuric oxide and obtained what he later described as “dephlogisticated air.” The gas discovered by Priestley was oxygen—the agent ubiquitous in modern medicine.1


First Therapeutic Use

Advancing Priestley’s discovery, Antoine Lavoisier named the newly discovered gas oxygen. The transfer from laboratory bench to formulary came quickly, with the first therapeutic use by Caillens in 1783, only 8 years after Priestley’s publication.1


The Pneumatic Institution

The Pneumatic Institution was founded to administer oxygen therapy in adults with consumption, asthma, palsy, dropsy, king’s evil, and other diseases. Many techniques developed by the Pneumatic Institution are still used today, such as mouthpieces and corrugated crushable breathing tubes.1


Modern Medicine

The first record of the employment of continuous administration of oxygen in a 46-year-old woman suffering from pneumonia.1,2 


Seminal Work

Scott Haldane publishes “The Therapeutic Administration of Oxygen,” representing the origin of rational oxygen use and the foundation of treatment guidelines for which little has been fundamentally superseded today.1,3


Oxygen Therapy and World War I

Haldane’s methods were employed during World War I to treat soldiers and munitions workers who had been subjected to phosgene poisoning in the trenches all over Europe. Acute poisoning, after initial triage, was managed with portable equipment as near to the site of injury as possible. This “Haldane equipment” consisted of a pressurized cylinder, pressure regulator, reservoir bag attached to the regulator (rather than on the mask as today), and a tight-fitting mask with nonreturn valves.1


Consequences of Unlimited Use

By the mid-twentieth century, oxygen supplementation was widely accepted as a panacea for many conditions and used liberally, including in the treatment of infants with hypoxic respiratory failure and related conditions. This liberal approach resulted in severe developmental consequences, including development of retinopathy of prematurity.4


Higher Rates of Mortality

Severe consequences associated with liberal application of supplemental oxygen required treatment protocols to shift toward a more conservative approach.5 Decreased use of oxygen supplementation (<50%) resulted in higher rates of mortality despite prevention of blindness.6


Advent of Pulse Oximetry

The pulse oximeter was developed to monitor oxygen saturation levels, and the American Academy of Pediatrics provided guidelines for desired saturation levels in infants (SaO2 85%-95%).7 The advent of this technology and subsequent guidelines have significantly improved the risk of adverse events associated with too liberal and too conservative applications of oxygen supplementation.4


Formation of the International Liaison Committee on Resuscitation (ILCOR)

In 1992, ILCOR was formed to help facilitate the formation of consensus and treatment recommendations from various resuscitation organizations worldwide. It included representatives from the American Heart Association (AHA), European Resuscitation Council (ERC), and the Heart and Stroke Foundation of Canada (HSFC), among others.8


ILCOR Publishes First Guidelines for Cardiopulminary Resuscitation and Care

Following a 1999 American Heart Association–hosted meeting, ILCOR publishes the first set of guidelines for pulmonary resuscitation and emergency cardiovascular care.8 An update addressing neonatal resuscitation was published in 2005.9


ILCOR Releases Updated Cardiopulmonary Resuscitation Treatment Recommendations

Current guidelines that review the consensus science statements and treatment recommendations with input from select members of ILCOR.10