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. 2011 Jan;37(1):46-51.
doi: 10.1007/s00134-010-2025-z. Epub 2010 Sep 28.

Clinicians' response to hyperoxia in ventilated patients in a Dutch ICU depends on the level of FiO2

Aafke Elizabeth de Graaff  1 , Dave Anton Dongelmans, Jan Maria Binnekade, Evert de Jonge
Affiliations

Clinicians' response to hyperoxia in ventilated patients in a Dutch ICU depends on the level of FiO2

Aafke Elizabeth de Graaff et al. Intensive Care Med. 2011 Jan.

Abstract

Purpose: Hyperoxia may induce pulmonary injury and may increase oxidative stress. In this retrospective database study we aimed to evaluate the response to hyperoxia by intensivists in a Dutch academic intensive care unit.

Methods: All arterial blood gas (ABG) data from mechanically ventilated patients from 2005 until 2009 were extracted from an electronic storage database of a mixed 32-bed intensive care unit in a university hospital in Amsterdam. Mechanical ventilation settings at the time of the ABG tests were retrieved.

Results: The results of 126,778 ABG tests from 5,498 mechanically ventilated patients were retrieved including corresponding ventilator settings. In 28,222 (22%) of the ABG tests the arterial oxygen tension (PaO(2)) was >16 kPa (120 mmHg). In only 25% of the tests with PaO(2) >16 kPa (120 mmHg) was the fraction of inspired oxygen (FiO(2)) decreased. Hyperoxia was accepted without adjustment in ventilator settings if FiO(2) was 0.4 or lower.

Conclusion: Hyperoxia is frequently seen but in most cases does not lead to adjustment of ventilator settings if FiO(2) <0.41. Implementation of guidelines concerning oxygen therapy should be improved and further research is needed concerning the effects of frequently encountered hyperoxia.

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Comment in

  • Oxygen: when is more the enemy of good?
    Branson RD, Robinson BR. Branson RD, et al. Intensive Care Med. 2011 Jan;37(1):1-3. doi: 10.1007/s00134-010-2034-y. Epub 2010 Sep 28. Intensive Care Med. 2011. PMID: 20878145 Free PMC article. No abstract available.

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