Oxygen Delivery Devices Research Articles

Development and validation of a novel fibre-optic respiratory rate sensor (FiRRS) integrated in oxygen delivery devices

Respiratory rate (RR) monitoring provides crucial information on the overall health condition of patients and a reliable, low cost RR monitor for normal hospital inpatient or home use would be of significant benefit. The proposed system measures light reflection from a Fibre Bragg Grating (FBG) located near, and the total reflection spectrum from a humidity sensing film deposited at, the tip of an optical fibre. Every breath causes a shift in the wavelength reflected from the FBG and intensity change in the overall reflection spectrum. The accuracy of different techniques is investigated in a two-part study with 15 healthy volunteers. In part 1, the participants’ respiration rate followed a handheld mobile application at 5, 12 and 30 breaths per minute with simultaneous measurement using the optical fibre system, thoracic impedance pneumography (TIP) and capnometry device (where possible). Two types of medical face masks and a nasal cannula with oxygen delivery rates were investigated. In part 2, participants wore an anaesthetic face mask and breathed at normal and low tidal volumes to evaluate whether low tidal volumes could be detected. The most accurate measurement of RR was through monitoring the Bragg wavelength shift (mean accuracy = 88.1%), followed by the intensity change at the Bragg wavelength (mean accuracy = 78.9%), capnometry (mean accuracy = 77.8%), area under the overall spectrum (mean accuracy = 65.4%) and TIP (mean accuracy = 43.1%). The Fibre-optic Respiratory Rate Sensor system (FiRRS) can differentiate between normal and low tidal volumes (p-value < 0.05) and demonstrated higher accuracy than capnometry measurement of end-tidal carbon dioxide in exhaled air. These latter two monitors measured RR more accurately than TIP. A comparable accuracy in the measurement of RR was obtained when the FiRRS was implemented in nasal cannula and face masks.

Maternal Oxygen Supplementation Compared With Room Air for Intrauterine Resuscitation

Supplemental oxygen is commonly administered to pregnant women at the time of delivery to prevent fetal hypoxia and acidemia. There is mixed evidence on the utility of this practice. To compare the association of peripartum maternal oxygen administration with room air on umbilical artery (UA) gas measures and neonatal outcomes. Ovid MEDLINE, Embase, Scopus, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials were searched from February 18 to April 3, 2020. Search terms included labor or obstetric delivery and oxygen therapy and fetal blood or blood gas or acid-base imbalance. Studies were included if they were randomized clinical trials comparing oxygen with room air at the time of scheduled cesarean delivery or labor in patients with singleton, nonanomalous pregnancies. Studies that did not collect paired umbilical cord gas samples or did not report either UA pH or UA Pao2 results were excluded. Data were extracted by 2 independent reviewers. The analysis was stratified by the presence or absence of labor at the time of randomization. Data were pooled using random-effects models. The primary outcome for this review was UA pH. Secondary outcomes included UA pH less than 7.2, UA Pao2, UA base excess, 1- and 5-minute Apgar scores, and neonatal intensive care unit admission. The meta-analysis included 16 randomized clinical trials (n = 1078 oxygen group and n = 974 room air group). There was significant heterogeneity among the studies (I2 = 49.88%; P = .03). Overall, oxygen administration was associated with no significant difference in UA pH (weighted mean difference, 0.00; 95% CI, -0.01 to 0.01). Oxygen use was associated with an increase in UA Pao2 (weighted mean difference, 2.57 mm Hg; 95% CI, 0.80-4.34 mm Hg) but no significant difference in UA base excess, UA pH less than 7.2, Apgar scores, or neonatal intensive care unit admissions. Umbilical artery pH values remained similar between groups after accounting for the risk of bias, type of oxygen delivery device, and fraction of inspired oxygen. After stratifying by the presence or absence of labor, oxygen administration in women undergoing scheduled cesarean delivery was associated with increased UA Pao2 (weighted mean difference, 2.12 mm Hg; 95% CI, 0.09-4.15 mm Hg) and a reduction in the incidence of UA pH less than 7.2 (relative risk, 0.63; 95% CI, 0.43-0.90), but these changes were not noted among those in labor (Pao2: weighted mean difference, 3.60 mm Hg; 95% CI, -0.30 to 7.49 mm Hg; UA pH<7.2: relative risk, 1.34; 95% CI, 0.58-3.11). This systematic review and meta-analysis suggests that studies to date showed no association between maternal oxygen and a clinically relevant improvement in UA pH or other neonatal outcomes.

Safety and Efficacy of Early Ambulation on an Alternative Oxygen Delivery Device for Patients Receiving Bedside Heated Humidified High-Flow Nasal Cannula Therapy

Purpose: Patients in the intensive care unit (ICU) receiving heated humidified high-flow nasal cannula (HHFNC) therapy for acute respiratory failure have limited ambulation distance due to restrictions in supplying HHFNC away from bedside. This study investigated the safety and efficacy of transitioning patients requiring HHFNC to a portable high-flow oxygen (HFO2) device for ambulation. Methods: Twenty-three patients with acute respiratory failure participated in this prospective longitudinal observational study. Three diagnostic groups were formed (cardiac n = 8; pulmonary n = 11; and other n = 4). Initial aerobic tolerance was established through bedside marching on HHFNC, then participants transitioned to HFO2 for ambulation. During each phase, vital signs were monitored. Results: No differences were found among diagnostic groups or sexes during ambulation for blood pressure, heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), or the Borg dyspnea scale (BDS) (all P &gt; .05). Outcomes during marching and ambulation differed from outcomes at rest and during recovery for HR, RR, SpO2, and BDS (all P &lt; .001). Transitory adverse events during ambulation included anxiety (n = 2), hypotension (n = 1), and arrhythmia (n = 2). Conclusions: Results indicate it is safe and efficacious for patients in the ICU with acute respiratory failure requiring HHFNC to ambulate on HFO2 under the supervision of a physical therapist.

Enrichment of Oxygen Concentration Over Simulated Corneal Surface Through Noncontact Oxygen Delivery Device.

To demonstrate a noncontact device to enrich oxygen concentration during corneal cross-linking (CXL). An oxygen delivery device was tested in a laboratory mock-up. The device comprises a clear polycarbonate tube of 14 cm in length and 1.58 cm inner diameter. Compressed oxygen gas is delivered to the tube from a side opening. The oximeter was attached to a sampling tube 3 mm above the apex of a scleral lens that simulates the cornea. The lens was mounted on a mannequin face. During each experimental run, the oximeter reading was recorded manually every 30 seconds for 4.5 minutes after the flow regulator was opened to the preset flow rate. Three flow rates of 0.25, 0.50, and 1 L/min were tested with all three cornea-tube distances of 8, 10, and 14 mm. The baseline oxygen concentration was 20.9%. The oxygen concentration reached plateau levels after 2 to 3.5 minutes. Oxygen measurements were averaged over the three time points in the plateau phase between 3.5 and 4.5 minutes. Atmospheric oxygen concentration above the simulated cornea was found to be strongly dependent on the oxygen flow rate up to 1 L/min. At the 1 L/min flow rate, 99% concentration was achieved at 8 to 10 mm of cornea-tube distances, and dropped to 90% at 14 mm. Atmospheric oxygen concentration can be boosted to more than 90% using a noncontact device. This could potentially improve the effectiveness of accelerated CXL by boosting oxygen transport more than fourfold. [J Refract Surg. 2020;36(9):613-616.].

An economic evaluation examining the cost-effectiveness of continuous diffusion of oxygen therapy for individuals with diabetic foot ulcers.

Continuous delivery of oxygen therapy has been observed to improve healing for individuals with an advanced diabetic foot ulcer (DFU). However, this intervention requires the purchasing of an oxygen delivery device and moist dressings. It is unknown whether this upfront financial investment represents good value for money. Thus the aim of this project is to evaluate the cost‐effectiveness of treating advanced DFU using continuous delivery of oxygen compared with negative pressure wound therapy from the perspective of the public health care payer in Ontario, Canada. A microsimulation model was constructed with inputs from peer‐reviewed journal publications and publicly available reports. The 5‐year costs and quality‐adjusted life‐years were compared between treatment and comparator. Sensitivity analyses were conducted to evaluate the robustness of results. The model predicted that continuous delivery of oxygen would cost $4800 less compared with negative pressure wound therapy and increased quality‐adjusted life years by 0.025. Lower cost and improved outcomes were observed in most scenario analyses. The results of this economic evaluation suggest that CDO therapy may reduce health care economic burden with a modest increase in quality of life outcomes. Health care decision‐makers should consider the inclusion of CDO for the treatment of DFU.

The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial.

BackgroundAccording to the literature, 20–30% of intubated patients are difficult to wean off mechanical ventilation and have a prolonged intensive care unit (ICU) stay with detrimental effects on muscle strength, functional ability and quality of life. Inspiratory muscle training (IMT) via a threshold device has been proposed as an effective exercise for minimising the effects of mechanical ventilation on respiratory muscles of critically ill patients with prolonged weaning. In addition, high-flow nasal cannula (HFNC) oxygen has been proved to provide efficient support for both high- and low-risk patients after extubation, thus preventing re-intubation.Material and methodsA randomised controlled trial was designed to assess the efficacy of combining IMT and HFNC as therapeutic strategies for patients with high risk for weaning failure. Once patients with prognostic factors of difficult weaning are awake, ventilated with support settings and cooperative, they will be randomised to one of the two following study groups: intervention group (IMT and HFNC) and control group (IMT and Venturi mask). IMT will start as soon as possible. Each allocated oxygen delivery device will be applied immediately after extubation. IMT intervention will continue until patients' discharge from ICU. The primary outcome is the rate of weaning failure. Secondary outcomes are maximal inspiratory and expiratory strength, endurance of respiratory muscles, global muscle strength, functional ability and quality of life along with duration of ventilation (days) and ICU and hospital length of stay.ConclusionThe present study could significantly contribute to knowledge of how best to treat patients with difficult weaning and high risk of re-intubation.

Characterizing a novel in-situ oxygen delivery device for establishing controlled redox zonation within a high infiltration rate sequential biofilter

By applying favorable oxic and oligotrophic conditions through subsequent aeration and an additional infiltration step, the sequential managed aquifer recharge technology (SMART) was proven to better remove trace organic chemicals (TOrCs) than conventional MAR systems. To minimize the physical footprint, pumping costs and hydraulic retention times, as well as to overcome limitations of site-specific heterogeneities of such systems, the SMART concept was further upgraded by two main engineered technologies. This SMARTplus bioreactor is comprised of an infiltration trench and highly homogenous porous media to provide high infiltration rates and plug-flow conditions. Additionally, an in-situ oxygen delivery device, in particular a self-designed PDMS gas-liquid membrane contactor, was designed to establish favorable subsurface oxic conditions. This novel SMARTplus technology was investigated at pilot scale and is designed for advanced water treatment either in the context of water reuse or treatment of impaired surface water. To determine the design specifications and to construct a pilot-scale membrane contactor, the mass transfer coefficients of the PDMS membrane were investigated at lab-scale for varying Reynold numbers (0.2–2). With the help of the customized membrane contactor, homogenous, bubble-free and passive oxygen delivery could be successfully demonstrated at pilot-scale under laminar flow conditions and short contact times. Oxygen concentrations downstream of the membrane contactors met the design specifications (>1 mg/L) as long as the required feed water quality was provided. However, high NH4+ concentrations in the secondary effluent resulted in higher and unsteady oxygen demand than the target oxygen transfer rates could meet and suboxic conditions prevailed. Although a 20–50% enhancement in the removal of certain compounds (4-FAA, antipyrine, sulfamethoxazole, and citalopram) was achieved, demonstration of the full potential of enhanced TOrC removal by SMARTplus was hindered due to unsteady feed water quality.

COVID-19 in Liver Transplant Recipients: An Initial Experience From the US Epicenter

COVID-19 in Liver Transplant Recipients: An Initial Experience From the US Epicenter

Oxygen delivery devices in Covid-19 patients: Review and recommendation

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has become a matter of concern all over the world. This virus caused acute respiratory distress syndrome(ARDS) in almost 67% of patients, with 71% of total patients requiring mechanical ventilation. Oxygen therapy is prudent for patients suffering fromSARS-CoV-2 at different stages of the disease. The choice of different oxygen delivery devices depends on the patient's status and its availability. In this review we will discuss the pros and cons of several oxygen delivery devices, as well as the safety precautions and personal protective equipments.

Impact of Oxygen Delivery Patterns on Arterial Oxygen Saturation Among Children

Background: Adequate oxygenation to treat hypoxia by suitable oxygen delivery pattern is the essence of pediatric critical care medicine. Monitoring oxygen saturation (SpO 2 ) is thus essential in order to decide course of treatment. It is commonly carried out using painless sequential non-invasive pulse oximetry as well by severely painful random arterial blood gas (ABG) analysis. Methods: This study compared both methods to determine the impact of various oxygen delivery patterns upon SpO 2 at bedside for meaningful and continuous evaluation. In a prospective cohort adopted for study, 60 children from acute pediatric wards of an academic tertiary referral hospital were observed. Children were eligible for enrollment using cross sectional approach, if the treating pediatricians ordered an ABG, on pulse oximetry monitoring with oxygen support by any oxygen delivery device using a validated checklist. Results: Among all the samples, 60 % were infants and 55 % were male. Complaints on admission were vomiting (35%), shortness of breath (33%), diarrhea (28%), lethargy (31%) and Kussmaul breathing (30%). SpO 2 was > 90% for 88% of children. Oxy hood box was used to deliver oxygen to 73% of children. SpO 2 had positive correlation with oxygen delivery methods (r = 0.8) and partial pressure of oxygen (PaO 2 ) by ABG analysis had positive correlation with SpO 2 by pulse oximetry (r = 0.9). Conclusions: Pulse oximetry can be used as a reliable bed side tool to evaluate oxygen delivery patterns and diagnose early respiratory failure in emergency settings where ABG analysis facility is not available. Int J Clin Pediatr. 2020;9(3):72-76 doi: https://doi.org/10.14740/ijcp388

Contemporary portable oxygen concentrators and diverse breathing behaviours -- a bench comparison

BackgroundDecades of clinical research into pulsed oxygen delivery has shown variable efficacy between users, and across a user’s behaviours (sleep, rest, activity). Modern portable oxygen concentrators (POCs) have been shown as effective as other oxygen delivery devices in many circumstances. However, there are concerns that they are not effective during sleep when the breathing is shallow, and at very high respiratory rates as during physical exertion. It can be challenging to examine the determinants of POC efficacy clinically due to the heterogeneity of lung function within oxygen users, the diversity of user behaviour, and measurement issues. Representative bench testing may help identify key determinants of pulsed-oxygen device efficacy.MethodsThree contemporary devices were bench-evaluated across three simulated breathing behaviours: activity, rest, & oronasal breathing during sleep. Emphasis was placed on breathing patterns representative of oxygen users.ResultsAll three POCs performed well during simulated breathing during exertion and at rest. Differences in triggering ability were noted for the scenario of oronasal breathing during sleep.ConclusionsThe results are supportive of contemporary POC triggering abilities. The differences shown in ultimate trigger sensitivity may have relevance to oronasal breathing during sleep or other challenging scenarios for pulsed oxygen delivery, such as dominant mouth breathing during exertion or unfavourable nasal geometry.

2018 Year in Review: Noninvasive Respiratory Support.

Noninvasive respiratory support refers to strategies aimed at providing oxygenation and/or ventilation without the use of an artificial airway. These strategies include the use of standard oxygen delivery devices (face masks, low-flow nasal cannulas), noninvasive ventilation, and high-flow nasal cannula. Considerable interest has been generated recently as to which therapy provides the optimum noninvasive support. This review examined the important literature related to noninvasive respiratory support published in 2018.

Nasal high flow: physiology, efficacy and safety in the acute care setting, a narrative review.

Nasal high flow (NHF) is a promising novel oxygen delivery device, whose mechanisms of action offer some beneficial effects over conventional oxygen systems. It is considered to have a number of physiological effects: it improves oxygenation, dynamic lung compliance, homogeneity and end expiratory lung volume; it decreases anatomical dead space and generates a positive airway pressure that can reduce respiratory rate, the work of breathing, and enhance patient comfort. NHF has been used as a prophylactic tool or as a treatment device mostly in patients with acute hypoxemic respiratory failure such as pre-oxygenation before intubation, immunocompromised patients and acute heart failure. Moreover, there is some evidence that NHF could be used during procedural sedation. Finally, NHF was deemed to be effective in chronic obstructive pulmonary disease patients with its positive end expiratory pressure effects and dead-space washout. However, careful monitoring is crucial to maximize NHF settings aimed at maximizing patient comfort while limiting the risk of delayed intubation. The present review presents the most updated evidence for NHF use in the adult acute care setting with the goal of providing clinicians with useful insights on the physiologic effects, main clinical indications, and safety issues of NHF treatment.

Royal Perth Hospital airway &amp; head and neck anesthesiology fellowship

Royal Perth Hospital airway &amp; head and neck anesthesiology fellowship

Mathematical modeling of oxygen release from hyperbarically loaded polymers.

Polymer-based scaffolds are used extensively in the field of regenerative medicine. These biomaterials may induce therapeutic responses through modulating a wound microenvironment with or without the addition of cells. It has long been known that oxygen is a crucial component of the microenvironment that influences cellular and physiological processes such as metabolism, proliferation, differentiation, matrix deposition, phagocytic killing, and wound healing. Consequently, several studies have investigated the potential for using oxygen-eluting biomaterials to regulate the oxygen tension within a wound microenvironment and to tune the regenerative response. We recently demonstrated that hyperbarically loaded polymers could be used as oxygen delivery devices for biomedical uses. To further develop this strategy, it is important to quantitatively characterize the spatiotemporal oxygen diffusion profile from scaffolds. Here, we use analytical and numerical solutions to describe the profiles of oxygen diffusion from hyperbarically loaded polymers as a function of different scaffold geometries, material compositions, and ambient temperatures. © 2018 American Institute of Chemical Engineers Biotechnol. Prog., 2018 © 2018 American Institute of Chemical Engineers Biotechnol. Prog., 35: e2751, 2019.

Preparedness of dental clinics for medical emergencies in Riyadh, Saudi Arabia

AimTo assess knowledge, training of dental staff and the availability of emergency drugs and equipment in dental clinics, Riyadh, Saudi Arabia. MethodsCross-sectional survey was conducted in a random sample (N: 325) of governmental and private clinics in Riyadh, Saudi Arabia, between June-December 2016. Questions included Dentist’s specialty, age, years of experience, knowledge and preparedness to handle ME (level of training, types of emergency drugs and equipment available). ResultsOne dentist from each clinic filled the questionnaire (100% of the sample), 19% of whom were general dentists. Medical history is taken orally by 86% of respondents before dental treatment and 12% take vital signs every visit.Of the surveyed clinics, 30% didn’t have emergency contact numbers available, 78% didn’t have an emergency protocol and only 54% have a medical emergency plan with 11% performing periodic office emergency drills.The most available emergency drug and equipment were Aspirin (53%) and Sphygmomanometer (86%). Oxygen delivery device was not available in 90% of the surveyed clinics. ConclusionThere is an alarming inadequacy of clinic/staff preparation to deal with ME. Efforts should be made to increasethe awareness of dentists to take needed precautions and prepare their clinics.

Performance of blow-by methods in delivering oxygen to pediatric patients during transport: A laboratory study.

Providing supplemental oxygen with a blow-by method is used to provide additional oxygen to patients who will not tolerate an oxygen delivery device in direct contact with their face. Blow-by methods are often improvised from parts of standard equipment. The performance is very dependent on the distance to the face and the direction of the gas flow. Blow-by methods are used by anesthetists during transport but their performance in delivering supplemental oxygen has only been tested in static situations. The aim of this nonclinical study was to determine the performance of different blow-by methods in the delivery of additional oxygen to pediatric patients during transport. A manikin of a child with a facemask of appropriate size was transported along a 60m corridor from the operating theater to the PACU. Oxygen delivery to the face of the manikin was measured during transport. Six blow-by methods were tested with oxygen flows of 3, 6, and 10L/min and with the facemask at 0cm from the face and at 5cm from the face. The outcome parameter was: blow-by method reaching and maintaining an FiO2 >50% during transport from the pediatric operating theater to the PACU. At 0cm from the face, five out of six blow-by methods maintained a FiO2 >50% with all three flow rates. At 5cm only two of the blow-by methods were able to maintain an FiO2 >50% and this only at flow rates of 10L/min. All other blow-by methods provided lower FiO2 s; in three, the FiO2 decreased to values only marginally above 21%. The decrease in FiO2 typically started within 6-12m from the start of the transport. It is concluded that the ability of blow-by methods to deliver a FiO2 >50% depends on the method used and distance from the face.

Approach to the Patient with Acute Respiratory Failure

Acute respiratory failure (ARF) is a common reason for admission to the intensive care unit (ICU), and is associated with significant morbidity and mortality. Failure of one or more components of the respiratory system can lead to hypoxemia, hypercabia, or both. Initial evaluation of patients with ARF should include physical examination, chest imaging, and arterial blood gases (ABG) sampling. As ARF is often a life-threatening emergency, a patient’s oxygenation and ventilation will need to be supported at the same time that diagnostic and therapeutic interventions are planned. The priorities for early treatment are essentially those of basic life support: airway and breathing. The first step is to assess a patient’s airway and ascertain that it is patent. This is followed by efforts to support both oxygenation and ventilation. This can include non-invasive or invasive mechanical ventilatory support. As with all interventions, there are risks inherent in the use of mechanical ventilation, which may be minimized by the use of lung protective ventilation (i.e., with low tidal volumes and airway pressures). Finally, due to the potential complications associated with mechanical ventilation, it is important to regularly assess whether a patient continues to require the assistance of the ventilator, and to liberate patients from mechanical ventilation at the earliest opportunity when clinically safe and feasible to do so. Figures depict pressure-time curve. Tables list the clinical causes of hypoxemic respiratory failure, oxygen delivery devices, indications for noninvasive positive pressure support, common causes of abnormal respiratory mechanics, and common causes of acute respiratory distress syndrome (ARDS). This review contains 2 highly rendered figures, 5 tables, and 86 references.

Superhydrophobic Photosensitizers: Airborne 1O2 Killing of an in Vitro Oral Biofilm at the Plastron Interface.

Singlet oxygen is a potent agent for the selective killing of a wide range of harmful cells; however, current delivery methods pose significant obstacles to its widespread use as a treatment agent. Limitations include the need for photosensitizer proximity to tissue because of the short (3.5 μs) lifetime of singlet oxygen in contact with water; the strong optical absorption of the photosensitizer, which limits the penetration depth; and hypoxic environments that restrict the concentration of available oxygen. In this article, we describe a novel superhydrophobic singlet oxygen delivery device for the selective inactivation of bacterial biofilms. The device addresses the current limitations by: immobilizing photosensitizer molecules onto inert silica particles; embedding the photosensitizer-containing particles into the plastron (i.e. the fluid-free space within a superhydrophobic surface between the solid substrate and fluid layer); distributing the particles along an optically transparent substrate such that they can be uniformly illuminated; enabling the penetration of oxygen via the contiguous vapor space defined by the plastron; and stabilizing the superhydrophobic state while avoiding the direct contact of the sensitizer to biomaterials. In this way, singlet oxygen generated on the sensitizer-containing particles can diffuse across the plastron and kill bacteria even deep within the hypoxic periodontal pockets. For the first time, we demonstrate complete biofilm inactivation (>5 log killing) of Porphyromonas gingivalis, a bacterium implicated in periodontal disease using the superhydrophobic singlet oxygen delivery device. The biofilms were cultured on hydroxyapatite disks and exposed to active and control surfaces to assess the killing efficiency as monitored by colony counting and confocal microscopy. Two sensitizer particle types, a silicon phthalocyanine sol-gel and a chlorin e6 derivative covalently bound to fluorinated silica, were evaluated; the biofilm killing efficiency was found to correlate with the amount of singlet oxygen detected in separate trapping studies. Finally, we discuss the applications of such devices in the treatment of periodontitis.

Operating Room Fires in Oculoplastic Surgery.

This study was performed to characterize the frequency, causes, and possible risk factors of operating room (OR) fires experienced by members of the American Society of Ophthalmic Plastic and Reconstructive Surgery. An online questionnaire was distributed to American Society of Ophthalmic Plastic and Reconstructive Surgery members, collecting data on surgical fires experienced by respondents throughout their careers. In addition, the questionnaire investigated viewpoints on OR fire safety, current practice patterns with oxygen delivery and surgical device usage, and management of patients referred after previous surgical fire exposure. There were 258 participants in the survey. Eighty-three surgeons (32.2%) experienced at least 1 surgical fire in their careers. Most OR fires occurred during monitored sedation cases with oxygen delivered by nasal cannula underneath drapes completely covering the head and use of a monopolar or battery-operated device. Patient hair and skin were the most common fuel sources, and most of the injuries were limited to singing of facial hair. Regarding current practice patterns, monopolar, bipolar, and battery-powered disposable devices were the most frequently used electrosurgery and electrocautery tools. Patients seen after an OR fire with another surgeon generally experienced more severe burns requiring hospitalization and subsequent procedures. Many oculoplastic surgeons have experienced OR fires during their careers. Certain surgical and anesthetic techniques, particularly the delivery of supplemental oxygen underneath surgical drapes and the use of monopolar electrosurgery and battery-powered electrocautery, may be associated with increased fire risk. While most of the reported OR fires did not result in significant patient injury, caution must be taken to prevent these potentially devastating events.