Clinicians' response to hyperoxia in ventilated patients in a Dutch ICU depends on the level of FiO2

Abstract

Purpose: 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 (PaO2) was >16 kPa (120 mmHg). In only 25% of the tests with PaO2 >16 kPa (120 mmHg) was the fraction of inspired oxygen (FiO2) decreased. Hyperoxia was accepted without adjustment in ventilator settings if FiO2 was 0.4 or lower. Conclusion: Hyperoxia is frequently seen but in most cases does not lead to adjustment of ventilator settings if FiO2 <0.41. Implementation of guidelines concerning oxygen therapy should be improved and further research is needed concerning the effects of frequently encountered hyperoxia. © 2010 The Author(s).