Venturi Mask (Air-Entrainment Mask) 

4

1. Definition

A Venturi mask is a high-flow oxygen delivery system that provides a fixed and controlled fraction of inspired oxygen (FiO₂) by entraining a predetermined amount of room air using the Venturi principle.Usually color coded.

It ensures:

  • Precise oxygen concentration
  • High total gas flow
  • Minimal influence of patient respiratory pattern


2. Principle of Venturi Mask

The functioning is based on two physical laws:

(A) Venturi Effect

When gas passes through a narrow constriction, velocity increases and lateral pressure decreases.

(B) Bernoulli Principle

The decrease in pressure around the jet draws surrounding air into the system through entrainment ports.

Result

High-velocity oxygen jet
↓
Negative pressure generated
↓
Room air entrained through side ports
↓
Mixing occurs
↓
Fixed oxygen concentration delivered



3. Air Entrainment Ratio

The ratio of entrained air to oxygen determines the FiO₂ delivered.


This produces a predictable oxygen concentration.


4. Color-Coded Venturi Valves(FiO₂ -24–60%)

Color

Oxygen Flow

Air:O₂ Ratio

Approx FiO₂

Blue

2 L/min

24:1

24%

White

4 L/min

10:1

28%

Orange

6 L/min

5:1

31%

Yellow

8 L/min

3:1

35%

Red

10 L/min

1.7:1

40%

Green

12–15 L/min

1:1

50–60%

Total gas flow may reach 40–60 L/min, which exceeds patient inspiratory demand.


5. Why Venturi Mask Provides Fixed FiO₂

Unlike simple masks or nasal cannula:

  • High total gas flow > patient inspiratory flow

Delivered FiO2 =Set FiO2

This is why it is called a fixed performance device.


6. Venturi Mask vs Other Oxygen Devices

Feature

Nasal Cannula

Simple Mask

Venturi Mask

Device type

Low flow

Low flow

High flow

FiO₂

Variable

Variable

Fixed

Precision

Low

Moderate

Very high

Max FiO₂

~44%

60%

~60%


7. Clinical Indications in ICU

1. COPD with Hypercapnia

Most important indication.

Reason:
Excess oxygen may worsen:

  • CO₂ retention
  • V/Q mismatch
  • Haldane effect

Venturi mask allows controlled oxygen (24–28%).


2. Acute Exacerbation of COPD

Oxygen Targets (Guideline Recommended)

Patient

Target SpO₂

COPD / hypercapnia risk

88–92%

Most ICU patients

92–96%


3. Type II Respiratory Failure

Used to avoid oxygen-induced hypercapnia.(Rise in PaCO₂ ≥5–10 mmHg after oxygen therapy)

  Mechanism 

Mechanism

V/Q mismatch(High oxygen reverses Hypoxic Pulmonary Vasoconstricton)

Haldane effect

Hypoventilation (hypoxic drive)


4. Post-extubation Oxygen Therapy

When controlled FiO₂ is required.


5. Moderate Hypoxemia

Used before escalating to:

  • HFNC
  • NIV
  • Mechanical ventilation


8. Common Errors in ICU Use

Blocking Air Entrainment Ports

Example:

  • Blanket covering ports

Result:

  • FiO₂ becomes unpredictably high


Wrong Oxygen Flow

Each valve requires specific flow rate.

If lower flow used:

  • Delivered FiO₂ changes.


Loose Mask Fit

Leads to:

  • Air leak
  • Lower FiO₂.

9. Troubleshooting

Problem

Cause

Solution

Low SpO₂

Disease progression

Increase FiO₂ valve

High CO₂

Excess oxygen

Reduce FiO₂

Poor oxygen delivery

Blocked ports

Clear ports

Patient discomfort

Mask tightness

Adjust fit



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