Intensive care clinicians’ opinion of conservative oxygen therapy (SpO2 90–92%) for mechanically ventilated patients: A survey

Abstract

Aim: We sought to explore intensive care clinicians’ opinion of conservative oxygen therapy for mechanically ventilated adult patients. Administering more oxygen than necessary may be injurious to lung tissue and systemically associated with hyperoxia. To reduce exposure to hyperoxia a conservative oxygen therapy protocol (targeted SpO2 90–92% using lowest FiO2) for mechanically ventilated patients was introduced in a single tertiary ICU in September, 2012. Methods: A structured multi-choice questionnaire of intensive care clinicians was conducted between February and March 2013. Institutional ethics committee approval was obtained. Results: Responses were received from 90 staff members: 81 intensive care nurses and nine medical doctors. A majority of respondents (60.7%) considered oxygen related lung injury as ‘a major concern’. Most respondents (81/89; 91.1%) felt conservative oxygen therapy was easy to perform and few respondents (6/88; 8%) considered performing conservative oxygen therapy to be stressful. Most respondents (58%) reported not performing more arterial blood gases to monitor PaO2 during conservative oxygen therapy and 90% (81/90) of respondents indicated a desire to continue conservative oxygen therapy. Free text comments show a paradigm shift yet more education and research to elucidate the benefits/harm of lower SpO2 targeting is needed. Conclusions: Intensive care clinicians readily incorporated conservative oxygen therapy into their practice. Most respondents found conservative oxygen therapy easy and not stressful to perform. Further evaluation of intensive care clinician's administration and management of oxygen therapy and possible impact on outcome for mechanically ventilated patients appears desirable.