Oxygen therapy

Hedley-Whyte, John; Winter, P. M.

doi:10.1002/cpt196785696

Cited by 24 publications

(4 citation statements)

References 48 publications

(57 reference statements)

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“…Our findings are in line with the recent guidelines of the European Society of Intensive Care Medicine (ESICM) on the management of mechanical ventilation in patients with an acute brain injury which, with a low level of evidence, recommend targeting normoxia (80-120 mmHg) regardless of the presence of intracranial pressure (ICP) elevation while it remains unknown whether a certain threshold of high PaO 2 should be considered safe in TBI patients [20]. The pathophysiological mechanisms behind the role of oxygen toxicity induced by hyperoxia (i.e., high FiO 2 ) [31,32] and hyperoxemia (i.e., high PaO 2 ) [33,34] in humans are widely recognized [5,35]. On the one hand, hyperoxia has been shown to induce direct pulmonary toxicity by alveolar-capillary leak and fibrogenesis in healthy volunteers [36] and to have cytotoxic properties [37][38][39].…”

Section: Discussionmentioning

confidence: 99%

High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI

et al. 2022

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Purpose:The effect of high arterial oxygen levels and supplemental oxygen administration on outcomes in traumatic brain injury (TBI) is debated, and data from large cohorts of TBI patients are limited. We investigated whether exposure to high blood oxygen levels and high oxygen supplementation is independently associated with outcomes in TBI patients admitted to the intensive care unit (ICU) and undergoing mechanical ventilation.Methods: This is a secondary analysis of two multicenter, prospective, observational, cohort studies performed in Europe and Australia. In TBI patients admitted to ICU, we describe the arterial partial pressure of oxygen (PaO 2 ) and the oxygen inspired fraction (FiO 2 ). We explored the association between high PaO 2 and FiO 2 levels within the first week with clinical outcomes. Furthermore, in the CENTER-TBI cohort, we investigate whether PaO 2 and FiO 2 levels may have differential relationships with outcome in the presence of varying levels of brain injury severity (as quantified by levels of glial fibrillary acidic protein (GFAP) in blood samples obtained within 24 h of injury). Results:The analysis included 1084 patients (11,577 measurements) in the CENTER-TBI cohort, of whom 55% had an unfavorable outcome, and 26% died at a 6-month follow-up. Median PaO 2 ranged from 93 to 166 mmHg. Exposure to higher PaO 2 and FiO 2 in the first seven days after ICU admission was independently associated with a higher mortality rate. A trend of a higher mortality rate was partially confirmed in the OzENTER-TBI cohort (n = 159). GFAP was independently associated with mortality and functional neurologic outcome at follow-up, but it did not modulate the outcome impact of high PaO 2 levels, which remained independently associated with 6-month mortality.

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Section: Discussionmentioning

confidence: 99%

High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI

et al. 2022

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“…JWG12's standards must address challenges specific to home respiratory care. [4][5][6][7][8] Emergency power supply needs, increased fire risks during oxygen therapy, alarms systems management, and alarm signal transmission to remote places within the domiciliary environment are essential…”

Section: Challenges Of Respiratory Care In the Home Environmentmentioning

confidence: 99%

Improving Patient Safety and Essential Device Performance: International Standards for Home Respiratory Care Equipment

Milamed

Lasthaus²,

Hedley-Whyte³

2013

Biomedical Instrumentation & Technology

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Recognition of the increasing use of medical devices in the home environment led to the establishment in 2006 of the International Electrotechnical Commission (IEC)Technical Committee 62A(IEC62A)-International Organization for Standardization (ISO)Technical Committee 121, Subcommittee 3: Anaesthetic and Respiratory Equipment, Lung Ventilators and Related Devices, (ISO/TC121/SC3), Joint Working Group 6 (JWG6) on medical electrical equipment and medical electrical systems used in the home healthcare environment. Publication of IEC Collateral Standard 60601-1-11 on home healthcare environment followed in June 2010, 1,2 with recognition in the Official Journal of the European Union as of Jan. 18, 2011. 3 This International Standard is also used to demonstrate the presumption of conformity with the Essential Requirements in the framework of the European Medical Device Directive, the precondition to enter the European market. Subsequently, the leadership of ISO/TC121/SC3 reviewed its Work Programme to identify respiratory care devices commonly used in the home. Existing standards covering those devices were also identified (Table 1).

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“…Oxygen therapy is essential in clinical states of respiratory failure such as pneumonia, severe asthma, chronic bronchitis, myocardial infarction, and postoperative states. [1–3] Unnoticed hypoxia has been reported in admitted patients in many studies. [1–3] In various rural hospitals in the Papua New Guinea, 10% to 40% children had oxygen saturation less than 90%.…”

Section: Introductionmentioning

confidence: 99%

“…[1–3] Unnoticed hypoxia has been reported in admitted patients in many studies. [1–3] In various rural hospitals in the Papua New Guinea, 10% to 40% children had oxygen saturation less than 90%. [4] Similarly, 20% patients in post-anesthetic recovery room had hypoxia after intravenous sedation given for maxillofacial surgery.…”

Section: Introductionmentioning

confidence: 99%

Occurrence of hypoxia in the wards of a teaching hospital

et al. 2012

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Objective:Appearance of hypoxia in a patient may be an indicator of a serious medical condition that can have grave consequences. Clinical evaluation fails to detect majority of the patients of hypoxia, and therefore, it may remain unnoticed in the wards. We planned to assess the magnitude of hypoxia in different wards of our tertiary care hospital.Materials and Methods:We studied all the patients admitted in various medical and surgical wards during 1 week of study. Oxygen saturation (SpO2) was measured with the help of a pulse oximeter in all the patients who remained admitted for at least 24 h. Hypoxia was diagnosed in a patient when he had SpO2 less than 90%.Results:During the study period, 1167 patients were admitted in various wards of the hospital. Hypoxia was detected in 121 patients (10.36%). Among them, 7 (0.59%) patients were already having a diagnosis of respiratory failure, but were not on oxygen therapy while 5 (0.42%) patients were having SpO2 less than 90% despite of oxygen therapy. In 109 (9.34%) patients, hypoxia was detected incidentally.Conclusion:Unnoticed hypoxia was detected in a significant number of the patients admitted in the wards of the hospital. Therefore, it is concluded that oxygen saturation measurements should be included with other vital parameters like pulse, temperature, and blood pressure, in the monitoring chart of all the admitted patients.

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Oxygen therapy

Abstract: Mea'iurements of abnormalities in the interrelationship

Cited by 24 publications

References 48 publications

High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI

High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI

Improving Patient Safety and Essential Device Performance: International Standards for Home Respiratory Care Equipment

Occurrence of hypoxia in the wards of a teaching hospital

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