Monday, July 9, 2018


R.E.B.E.L. EM - Emergency Medicine Blog
REBEL Cast Ep 55 - July 9, 2018
"Background: Critically ill patients come to the ED all the time and it is almost reflexive to liberally administer oxygen in these acutely ill patients. Many providers may consider supplemental oxygen a harmless and potentially beneficial therapy in these patients, irrespective of the presence or absence of hypoxemia (i.e. hyperoxia). There have been several trials (Stroke Oxygen Study, Oxygen in AMI, & Oxygen in the ICU) that have shown harm with hyperoxia in the critically ill. This paper is a systematic review and meta-analysis evaluating the evidence base for liberal versus conservative oxygen therapy in this patient population...
Author Conclusion: “In acutely ill adults, high-quality evidence shows that liberal oxygen therapy increases mortality without improving other patient-important outcomes. Supplemental oxygen might become unfavorable above and SpO2 range of 94 – 96%. These results support the conservative administration of oxygen therapy.”
Clinical Take Home Point: In critically ill adults we should avoid hyperoxia as this increases mortality. Instead we should aim for a target SpO2 of 94 – 96% in these patients."