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. 2022 Nov 14;22(1):350.
doi: 10.1186/s12871-022-01884-2.

Practice of oxygen use in anesthesiology - a survey of the European Society of Anaesthesiology and Intensive Care

Martin Scharffenberg  1 , Thomas Weiss  1 , Jakob Wittenstein  1 , Katharina Krenn  1   2 , Magdalena Fleming  1   3 , Peter Biro  4 , Stefan De Hert  5 , Jan F A Hendrickx  6   7   8   9 , Daniela Ionescu  10 , Marcelo Gama de Abreu  11   12   13 ; European Society of Anaesthesiology and Intensive Care
Affiliations

Practice of oxygen use in anesthesiology - a survey of the European Society of Anaesthesiology and Intensive Care

Martin Scharffenberg et al. BMC Anesthesiol. .

Abstract

Background: Oxygen is one of the most commonly used drugs by anesthesiologists. The World Health Organization (WHO) gave recommendations regarding perioperative oxygen administration, but the practice of oxygen use in anesthesia, critical emergency, and intensive care medicine remains unclear.

Methods: We conducted an online survey among members of the European Society of Anaesthesiology and Intensive Care (ESAIC). The questionnaire consisted of 46 queries appraising the perioperative period, emergency medicine and in the intensive care, knowledge about current recommendations by the WHO, oxygen toxicity, and devices for supplemental oxygen therapy.

Results: Seven hundred ninety-eight ESAIC members (2.1% of all ESAIC members) completed the survey. Most respondents were board-certified and worked in hospitals with > 500 beds. The majority affirmed that they do not use specific protocols for oxygen administration. WHO recommendations are unknown to 42% of respondents, known but not followed by 14%, and known and followed by 24% of them. Respondents prefer inspiratory oxygen fraction (FiO2) ≥80% during induction and emergence from anesthesia, but intraoperatively < 60% for maintenance, and higher FiO2 in patients with diseased than non-diseased lungs. Postoperative oxygen therapy is prescribed more commonly according to peripheral oxygen saturation (SpO2), but shortage of devices still limits monitoring. When monitoring is used, SpO2 ≤ 95% is often targeted. In critical emergency medicine, oxygen is used frequently in patients aged ≥80 years, or presenting with respiratory distress, chronic obstructive pulmonary disease, myocardial infarction, and stroke. In the intensive care unit, oxygen is mostly targeted at 96%, especially in patients with pulmonary diseases.

Conclusions: The current practice of perioperative oxygen therapy among respondents does not follow WHO recommendations or current evidence, and access to postoperative monitoring devices impairs the individualization of oxygen therapy. Further research and additional teaching about use of oxygen are necessary.

Keywords: Critical emergency medicine; Inspiratory fraction of oxygen; Intensive care medicine; Oxygen therapy; Oxygen toxicity; Patient safety; Perioperative care; Supplemental oxygen; WHO guidelines on surgical site infection prevention.

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Conflict of interest statement

Dr. M. Gama de Abreu received consultation fees from Ambu, GE Healthcare, ZOLL and Dräger Medical AG. Dr. K. Krenn reports travel grants from Biotest and a grant from Apeptico GmbH. All other authors (MS, TW, JW, MF, PB, SDH, JFAH, and DI) declared no competing interests.

Figures

Fig. 1
Fig. 1
Respondent’s knowledge and acceptance of the recent guidelines of the World Health Organization
Fig. 2
Fig. 2
Preferred inspiratory oxygen fraction (FiO2) for induction of anaesthesia
Fig. 3
Fig. 3
Target SpO2 in mechanically ventilated patients with healthy (panel A) and diseased lungs (panel B)
See this image and copyright information in PMC

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