title: Optimizing Oxygenation in the Mechanically Ventilated Patient: Nursing Practice Implications.
abstract: Critical care nurses constitute front-line care provision for patients in the intensive care unit (ICU). Hypoxemic respiratory compromise/failure is a primary reason that patients require ICU admission and mechanical ventilation. Critical care nurses must possess advanced knowledge, skill, and judgment when caring for these patients to ensure that interventions aimed at optimizing oxygenation are both effective and safe. This article discusses fundamental aspects of respiratory physiology and clinical indices used to describe oxygenation status. Key nursing interventions including patient assessment, positioning, pharmacology, and managing hemodynamic parameters are discussed, emphasizing their effects toward mitigating ventilation-perfusion mismatch and optimizing oxygenation.
authors.affiliation: Department of Practice, Performance and Innovation, Health Systems Innovation and External Relations, Royal College of Physicians and Surgeons of Canada, 774 Echo Drive, Ottawa, Ontario K1S 5N8, Canada. Electronic address: gbarton@royalcollege.ca.
authors.forename: Glenn
authors.initials: G
authors.lastname: Barton
authors.affiliation: Faculty of Health Sciences, School of Nursing, University of Ottawa, 3245B Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada.
authors.forename: Brandi
authors.initials: B
authors.lastname: Vanderspank-Wright
authors.affiliation: Surgery, The Ottawa Hospital, General Campus, 450 Smyth Road, Ottawa, Ontario K1H 8M5, Canada.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Shea
mesh_terms: D064648:Critical Care Nursing / Q000592:standards*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007362:Intensive Care Units; D009730:Nursing Assessment; D010100:Oxygen / Q000378:metabolism*; D056888:Patient Positioning; D012121:Respiration, Artificial / Q000451:nursing*; D012128:Respiratory Distress Syndrome / Q000451:nursing*; D012131:Respiratory Insufficiency / Q000451:nursing*
chemical_list: D010100:Oxygen
keywords: Critical care nursing; Hypoxia; Mechanical ventilation; Oxygenation; Patient safety