The impact of a postoperative oxygen therapy protocol on use of pulse oximetry and oxygen therapy.
BACKGROUND
Recent evidence suggests that both pulse oximetry monitoring and oxygen (O2) therapy may be used inappropriately at times, implying the need for improved use of pulse oximetry by health-care providers.


METHODS
We studied the clinical and financial impact of a postoperative O2-therapy protocol in 2 groups of patients. Group 1 (n = 20) was comprised of patients whose physicians made all O2 therapy management decisions. Group 2 (n = 20) was comprised of patients whose O2 therapy management was performed by respiratory therapists according to an algorithm with a stop criterion of SpO2 > or = 92%. The duration of postoperative O2 therapy, the frequency of unnecessary O2 therapy, and group totals of SpO2 measurements were compared between groups using the Mann-Whitney Rank Sum Test.


RESULTS
O2 therapy was used on average (SD) 3.45 (1.28) days/patient in Group 1 and 2.1 (0.64) days/patient in Group 2 (p < 0.003). Sixteen Group-1 patients continued to receive O2 at least 24 hours after achieving a room-air SpO2 > or = 92%. Group 1 had 57 SpO2 measurements and Group 2 had 24 (p < 0.003). No adverse clinical events ascribed to hypoxemia were noted in either group.


CONCLUSIONS
Our experience suggest that implementing a uniform, clinically appropriate 'stop criterion' for low-flow O2 therapy in nonthoracic postoperative patients can shorten the duration of O2 therapy and reduce the number of SpO2 measurements without incurring additional complications.
Komara
J J
JJ
Cleveland Clinic Foundation, OH, USA.
Stoller
J K
JK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D003657:Decision Making; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010092:Oximetry / Q000592:standards*; D010102:Oxygen Inhalation Therapy / Q000592:standards*; D011182:Postoperative Care / Q000592:standards*; D011997:Recovery Room / Q000592:standards; D013997:Time Factors