Intensive care clinicians’ opinion of conservative oxygen therapy (SpO2 90–92%) for mechanically ventilated patients

Eastwood, Glenn M; Peck, Leah; Young, Helen; Suzuki, Satoshi; García, Mercedes; Bellomo, Rinaldo

doi:10.1016/j.aucc.2013.11.004

Cited by 19 publications

(18 citation statements)

References 26 publications

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“…By comparison, critically ill patients are nursed on a 1:1 nurse-patient ratio and the majority of intensive care nurses have a critical care qualification (14). Thus, while the findings of our study and the study by Eastwood et al (2013) provide encouraging bi-national practice data, their findings are likely to vary significantly from other international settings with differing levels of nursing expertise and critical care resource utilisation (9). As such, we urge a greater evaluation of nursing and critical care service provision regarding the administration of oxygen for mechanically ventilated patients.…”

contrasting

confidence: 45%

“…There were seven practice-oriented questions followed by one free-text question and one employment status question. The questionnaire was the conservative oxygen therapy questionnaire survey of Australian ICU clinicians by Eastwood et al (9). The survey was translated from English to Persian and pilot tested to ensure face and content validity.…”

Section: Questionnairementioning

confidence: 99%

“…Furthermore, these investigators recognised that introduction of the COT would be a challenge to the current practices and clinical norms of their ICU clinicians. As such, these investigators performed a questionnaire survey to ascertain the opinion regarding COT of their intensive care doctors and nurses (9). Survey findings identified that staff were concerned about oxygen-related lung injury; that COT was easy and not stressful to perform; COT did not result in more arterial blood gas (ABG) samples being taken; and, COT was to continue so long as further research evaluating the clinical impact of this approach was performed.…”

Section: Introductionmentioning

confidence: 99%

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Intensive Care Clinicians’ Attitudes and Self-Reported Practice of Conservative Oxygen Therapy

et al. 2015

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Background: Conservative oxygen therapy (COT) targets a SpO2 of 90 -92% using the lowest possible FiO2 for mechanically ventilated (MV) adult patients. Conservative oxygen therapy aims to maintain adequate oxygenation while avoiding the harmful effects of hyperoxaemia. However, a lower SpO2 target during MV is recognised as challenging in current clinical norms. Objectives: We sought to describe intensive care clinicians' opinion and self-reported practice of conservative oxygen therapy. Methods: The research tool was a multi-choice questionnaire of intensive care clinicians working at 10 affiliated metropolitan tertiary hospitals from January-April, 2014. Results: Four hundred and twelve (84%) staff members responded to the survey. Of these, 91% (375) were intensive care nurses and 9% (37) were medical doctors. A majority of respondents (86%, 356/412) considered oxygen-related lung injury as "Yes, a major concern". Most respondents, 85% (351/412), felt COT was easy to perform and a few respondents, 6% (23/412), considered performing COT to be stressful. More than 90% of the respondents reported not performing more arterial blood gases to monitor PaO2 during COT and essentially all (98%) indicated a desire to perform COT. Free text comments indicated COT as a challenge to current practice and expressed a strong desire to avoid inadvertent hypoxaemia. Conclusions: Intensive care clinicians varied in their opinion and self-reported practice of conservative oxygen therapy and were genuinely concerned about unintended physiological consequences related to targeting low SpO2 values. We recommend conservative oxygen therapy to be implemented cautiously in conjunction with further evaluation of its impact on outcomes for patients and the perceptions of clinicians.

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confidence: 45%

Section: Questionnairementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intensive Care Clinicians’ Attitudes and Self-Reported Practice of Conservative Oxygen Therapy

et al. 2015

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“…29 Moreover, a recent survey of almost 100 ICU clinicians identified that greater therapeutic awareness of oxygen administration practice coincided with the implementation of a conservative oxygen therapy approach. 37 Such awareness may influence weaning from mandatory mechanical ventilation following CA.…”

Section: Relationship With Previous Studiesmentioning

confidence: 99%

Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study

et al. 2016

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“…A definition of conservative oxygen therapy is in order before further discussion. According to Eastwood et al, 98 conservative oxygen therapy targets an F IO 2 of 90 -92% at the lowest possible F IO 2 . Although PEEP is an integral part of oxygenation management in the mechanically ventilated patient, PEEP is not involved in this definition.…”

Section: The Conservative Oxygen Therapy Trialsmentioning

confidence: 99%

Should Oxygen Therapy Be Tightly Regulated to Minimize Hyperoxia in Critically Ill Patients?

Kallet

Branson

2016

Respir Care

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Oxygen is both lifesaving and toxic. Appropriate use of oxygen aims to provide a balance between the two effects. Although local oxygen toxicity to the lung is well accepted, recent evidence has called into question the negative consequences of hyperoxemia in other organ beds. Hyperoxia following cardiac arrest, traumatic brain injury, and stroke has been shown to worsen outcomes. The role of hyperoxemia in mechanically ventilated patients, in the face of non-toxic inspired oxygen concentrations, is less clear. This paper will review the data for and against the use of conservative oxygen targets and the avoidance of hyperoxemia in mechanically ventilated patients. Key words: hyperoxia; hyperoxic acute lung injury; lung protective ventilation; oxygen toxicity; reactive oxygen species; ventilator-induced lung injury. [Respir Care 2016;61(6):801-817.

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Intensive care clinicians’ opinion of conservative oxygen therapy (SpO2 90–92%) for mechanically ventilated patients

Cited by 19 publications

References 26 publications

Intensive Care Clinicians’ Attitudes and Self-Reported Practice of Conservative Oxygen Therapy

Intensive Care Clinicians’ Attitudes and Self-Reported Practice of Conservative Oxygen Therapy

Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study

Should Oxygen Therapy Be Tightly Regulated to Minimize Hyperoxia in Critically Ill Patients?

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