Clinicians' response to hyperoxia in ventilated patients in a Dutch ICU depends on the level of FiO2.
OBJECTIVE
Hyperoxia may induce pulmonary injury and may increase oxidative stress. In this retrospective database study we aimed to evaluate the response to hyperoxia by intensivists in a Dutch academic intensive care unit.


METHODS
All arterial blood gas (ABG) data from mechanically ventilated patients from 2005 until 2009 were extracted from an electronic storage database of a mixed 32-bed intensive care unit in a university hospital in Amsterdam. Mechanical ventilation settings at the time of the ABG tests were retrieved.


RESULTS
The results of 126,778 ABG tests from 5,498 mechanically ventilated patients were retrieved including corresponding ventilator settings. In 28,222 (22%) of the ABG tests the arterial oxygen tension (PaO(2)) was >16 kPa (120 mmHg). In only 25% of the tests with PaO(2) >16 kPa (120 mmHg) was the fraction of inspired oxygen (FiO(2)) decreased. Hyperoxia was accepted without adjustment in ventilator settings if FiO(2) was 0.4 or lower.


CONCLUSIONS
Hyperoxia is frequently seen but in most cases does not lead to adjustment of ventilator settings if FiO(2) <0.41. Implementation of guidelines concerning oxygen therapy should be improved and further research is needed concerning the effects of frequently encountered hyperoxia.
de Graaff
Aafke Elizabeth
AE
Department of Intensive Care Medicine, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. degraaff.a.e@gmail.com
Dongelmans
Dave Anton
DA
Binnekade
Jan Maria
JM
de Jonge
Evert
E
D015331:Cohort Studies; D005260:Female; D006801:Humans; D018496:Hyperoxia / Q000139:chemically induced / Q000628:therapy*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010100:Oxygen / Q000008:administration & dosage* / Q000009:adverse effects; D012121:Respiration, Artificial / Q000379:methods; D012189:Retrospective Studies
D010100:Oxygen