Author/Authors :
Fathi ، Mohammad Anesthesia and Critical Care Department - Shahid Modares Hospital, Anesthesiology Research Center - Shahid Beheshti University of Medical Sciences , Farzanegan ، Behrooz Anesthesia and Critical Care Department - Masih Daneshvari Hospital, Tracheal Diseases Research Center - Shahid Beheshti University of Medical Sciences , Hajiesmaeili ، Mohammadreza Anesthesia and Critical Care Department - Loghman Hakim Hospital, Anesthesiology Research Center - Shahid Beheshti University of Medical Sciences , Vahedian-Azimi ، Amir Nursing Faculty, Trauma Research Center - Baqiyatallah University of Medical Sciences , Goharani ، Reza Anesthesia and Critical Care Department - Imam Hossein Hospital - Shahid Beheshti University of Medical Sciences , Rahimibashar ، Farshid Anesthesia and Critical Care Department - Hamadan University of Medical Sciences , Amirsavadkouhi ، Ali Anesthesia and Critical Care Department - Mehrad Hospital , Seifi ، Shahram Anesthesia and Critical Care Department - Rohani Hospital - Babol University of Medical Sciences , Sedaghat ، Alireza Anesthesia and Critical Care Medicine Department - Imam Reza Hospital - Mashhad University of Medical Sciences , Hatamian ، Sevak Anesthesia and Critical Care Department - Shahid Madani Hospital - Alborz University of Medical Sciences , Salarian ، Sara Mofid Hospital, Anesthesiology Research Center - Shahid Beheshti University of Medical Sciences , Khoshbin ، Masoud Anesthesia and Critical Care Department - Shah Vali Hospital - Islamic Azad University, Medical Science Branch , Khabirikhatiri ، Mohammadali Taleghani Hospital, Anesthesiology Research Center - Shahid Beheshti University of Medical Sciences , Basharzad ، Niloofar Internal Medicine Department - Masih Daneshvari Hospital - Shahid Beheshti University of Medical Sciences , Zangi ، Masoud Loghman Hakim Hospital, Anesthesiology Research Center - Shahid Beheshti University of Medical Sciences , Miri ، Mirmohammad Anesthesia and Critical Care Department - Imam Hossein Hospital - Shahid Beheshti University of Medical Sciences
Abstract :
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.
Keywords :
Conservative Oxygen Therapy , Hypoxemia , Hyperoxaemia , Intensive Care Unit
