Attitudes of Dutch intensive care unit clinicians towards oxygen therapy
Grim, C C A; Cornet, A D; Kroner, A; Meiners, A J; Brouwers, A J B W; Reidinga, A C; van Westerloo, D J; Bergmans, D C J J; Gommers, D; Versluis, D; Weller, D; Christiaan Boerma, E; van Driel, E; de Jonge, E; Schoonderbeek, F J; Helmerhorst, H J F; Jongsma-van Netten, H G; Weenink, J; Woittiez, K J; Simons, K S; van Ewelie, L; Petjak, M; Sigtermans, M J; van der Woude, M; Cremer, O L; Bijlstra, P; van der Heiden, P; So, R K L; Vink, R; Jansen, T; de Ruijter, W
(2020) The Netherlands journal of medicine, volume 78, issue 4, pp. 167 - 174
(Article)
Abstract
BACKGROUND: Over the last decade, there has been an increasing awareness for the potential harm of the administration of too much oxygen. We aimed to describe self-reported attitudes towards oxygen therapy by clinicians from a large representative sample of intensive care units (ICUs) in the Netherlands. METHODS: In April 2019,
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36 ICUs in the Netherlands were approached and asked to send out a questionnaire (59 questions) to their nursing and medical staff (ICU clinicians) eliciting self-reported behaviour and attitudes towards oxygen therapy in general and in specific ICU case scenarios. RESULTS: In total, 1361 ICU clinicians (71% nurses, 24% physicians) from 28 ICUs returned the questionnaire. Of responding ICU clinicians, 64% considered oxygen-induced lung injury to be a major concern. The majority of respondents considered a partial pressure of oxygen (PaO2) of 6-10 kPa (45-75 mmHg) and an arterial saturation (SaO2) of 85-90% as acceptable for 15 minutes, and a PaO2 7-10 kPa (53-75 mmHg) and SaO2 90-95% as acceptable for 24-48 hours in an acute respiratory distress syndrome (ARDS) patient. In most case scenarios, respondents reported not to change the fraction of inspired oxygen (FiO2) if SaO2 was 90-95% or PaO2 was 12 kPa (90 mmHg). CONCLUSION: A representative sample of ICU clinicians from the Netherlands were concerned about oxygen-induced lung injury, and reported that they preferred PaO2 and SaO2 targets in the lower physiological range and would adjust ventilation settings accordingly.
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Keywords: Conservative oxygenation, intensive care unit, mechanical ventilation, oxygen therapy, questionnaire, survey, Journal Article
ISSN: 0300-2977
Publisher: Van Zuiden Communications BV
(Peer reviewed)