title: Current oxygen management in mechanically ventilated patients: a prospective observational cohort study.
abstract: OBJECTIVE
  Oxygen (O2) is the most common therapy in mechanically ventilated patients, but targets and dose are poorly understood. We aimed to describe current O2 administration and titration in such patients in an academic intensive care unit.
  
  
  METHODS
  In consecutive ventilated (>48 hours) patients we prospectively obtained fraction of inspired O2 (FiO2), pulse oximetry O2 saturation (SpO2) and arterial O2 tension (PaO2) every 6 hours. We calculated the amount of excess O2 delivery and the intensivists' response to hyperoxemia (SpO2>98%).
  
  
  RESULTS
  During 358 mechanical ventilation days in 51 critically ill patients, median calculated excess O2 delivery was 3472 L per patient. Patients spent most of their time with their SpO2>98% (59% [29-83]) and PaO2 between 80 and 120 mm Hg (59% [38-72]). In addition, 50% of all observations showed hyperoxemia and 4% severe hyperoxemia (PaO2>202.5 mm Hg). Moreover, 71% of the calculated total excess 263,841 L of O2 was delivered when the Fio2 was 0.3 to 0.5. When hyperoxemia occurred with an Fio2 between 0.3 and 0.4, for 88% of episodes, no Fio2 adjustments were made.
  
  
  CONCLUSIONS
  Excess O2 delivery and liberal O2 therapy were common in mechanically ventilated patients. Current O2 therapy practice may be suboptimal and further investigations are warranted.
authors.affiliation: Department of Intensive Care, Austin Hospital, Heidelberg, Melbourne, Victoria, Australia.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Eastwood
authors.forename: Leah
authors.initials: L
authors.lastname: Peck
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Glassford
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D018806:APACHE; D000368:Aged; D001784:Blood Gas Analysis; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010100:Oxygen / Q000008:administration & dosage*; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011446:Prospective Studies; D012121:Respiration, Artificial
chemical_list: D010100:Oxygen
keywords: Fraction of inspired oxygen; Hyperoxia; Intensive care; Mechanical ventilation; Oxygen