Abstract
In medical emergencies, supplemental oxygen is often administrated routinely. Most paramedics and physicians believe that high concentrations of oxygen are life-saving [1]. Over the last century, however, a plethora of studies point to possible detrimental effects of hyperoxia induced by supplemental oxygen in a variety of medical emergencies. This viewpoint provides a historical overview and questions the safety of routine high-dose oxygen administration and is based on pathophysiology and (pre)clinical findings in various medical emergencies.
Highlights
In medical emergencies, supplemental oxygen is often administrated routinely
High concentrations of oxygen have significant adverse hemodynamic effects in patients with stable congestive heart failure (CHF). One of these hemodynamic studies had a randomized double-blind design [23], we found no epidemiological studies of supplemental oxygen therapy in CHF with clinical endpoints
High-dose oxygen is associated with a variety of hemodynamic alterations that may increase myocardial ischemia and impair cardiac performance
Summary
This viewpoint designates detrimental effects of routine administration of high-dose supplemental oxygen in a variety of medical emergencies. The British Thoracic Society guideline for emergency oxygen use in adult patients recommends immediate administration of high-concentration oxygen in all critically ill, hypoxic non-COPD patients to achieve a target peripheral oxygen saturation of 94% to 98% [52]. These guidelines do, underscore that there is little or no evidence to support the recommendations. Even mild levels of hyperoxia are associated with a decrease in perfusion of grey matter [55] Both hyperoxia and hypoxia may be detrimental for cerebral oxygenation. Can we safely come to evidence-based recommendations that will tell us when to start, and when to stop, administration of supplemental oxygen
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