Benefits and risks of oxygen therapy during acute medical illness: Just a matter of dose!

Benefits and risks of oxygen therapy during acute medical illness: Just a matter of dose! Rev Med Interne. 2019 May 01;: Authors: Allardet-Servent J, Sicard G, Metz V, Chiche L Abstract Oxygen therapy is used to reverse hypoxemia since more than a century. Current usage is broader and includes routine oxygen administration despite normoxemia which may result in prolonged periods of hyperoxemia. While systematic oxygen therapy was expected to be of benefit in some ischemic diseases such as stroke or acute myocardial infarction, recent randomised controlled trials (RCTs) have challenged this hypothesis by showing the absence of clinical improvement. Although oxygen is known to be toxic at high inspired oxygen fractions, a recent meta-analysis of RCTs revealed the life-threatening effect of hyperoxemia, with a dose-dependent relationship. Several recommendations have therefore been updated: (i) to monitor peripheral oxygen saturation (SpO2) as a surrogate for arterial oxygen saturation (SaO2); (ii) to initiate oxygen only when the lower SpO2 threshold is crossed; (iii) to titrate the delivered oxygen fraction to maintain SpO2 within a target range; and (iv) to stop supplying oxygen when the upper limit of SpO2 is surpassed, in order to prevent hyperoxemia. The lower and upper limits of SpO2 depend on the presence of risk factors for oxygen-induced hypercapnia (Chronic obstructive pulmonary disease, asthma, and obesity-associated hypoventilation). For patient...
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research

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Source: Neural Plasticity - Category: Neurology Authors: Tags: Neural Plast Source Type: research
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Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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Source: International Journal of Hyperthermia - Category: Internal Medicine Tags: Int J Hyperthermia Source Type: research
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Source: Cardiology Research and Practice - Category: Cardiology Authors: Tags: Cardiol Res Pract Source Type: research
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Source: International Neurourology Journal - Category: Urology & Nephrology Tags: Int Neurourol J Source Type: research
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Source: Diabetes Core Update - Category: Endocrinology Authors: Source Type: podcasts
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Source: Korean Journal of Parasitology - Category: Parasitology Tags: Korean J Parasitol Source Type: research
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