Oxygen therapy in non-intubated adult intensive care patients: a point prevalence study

Abstract

Background: Oxygen is commonly administered to intensive care unit patients. Although there is knowledge of how oxygen is administered to mechanically ventilated patients, there are few data about its use in non-intubated ICU patients.

Objective: To describe how oxygen therapy is prescribed, administered and monitored for non-intubated patients in New Zealand and Australian ICUs.

Design, participants and setting: Prospective, observational, binational, multicentre, 1-day point prevalence study of all adult patients in 40 New Zealand and Australian ICUs at 10 am on a study day.

Main outcome measures: We collected patient demographic data, 28-day mortality and details of oxygen therapy (oxygen therapy prescription, oxygen delivery device use and oxygen saturation targets).

Results: We audited 506 patients, of whom 178 (35.2%) were not intubated but receiving oxygen therapy; 59.5% were men. Their mean age was 57.3 years (SD, 18.8 years), mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16.2 (SD, 7.3) and 47.2% were admitted after surgery. Most patients (66%) received oxygen via simple nasal cannulae, and patients also received oxygen via open face mask, nasal high-flow and noninvasive ventilation. A documented prescription for oxygen therapy was in place for 24.4% of patients, and we considered 7% to be complete and comprehensive.

Conclusions: Oxygen therapy is commonly administered to non-intubated adult patients in New Zealand and Australian ICUs. Most patients received oxygen by simple nasal cannulae, and oxygen therapy prescriptions were often absent or incomplete. We advise continuing education to ensure that oxygen is prescribed, administered and documented correctly.