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Intensive care doctors’ preferences for arterial oxygen tension levels in mechanically ventilated patients

Schjørring, O. L. ; Toft-Petersen, A. P. ; Kusk, K. H. ; Mouncey, P. ; Sørensen, E. E. ; Berezowicz, P. ; Bestle, M. H. ; Bülow, H. H. ; Bundgaard, H. and Christensen, S. , et al. (2018) In Acta Anaesthesiologica Scandinavica 62(10). p.1443-1451
Abstract

Background: Oxygen is liberally administered in intensive care units (ICUs). Nevertheless, ICU doctors’ preferences for supplementing oxygen are inadequately described. The aim was to identify ICU doctors’ preferences for arterial oxygenation levels in mechanically ventilated adult ICU patients. Methods: In April to August 2016, an online multiple-choice 17-part-questionnaire was distributed to 1080 ICU doctors in seven Northern European countries. Repeated reminder e-mails were sent. The study ended in October 2016. Results: The response rate was 63%. When evaluating oxygenation 52% of respondents rated arterial oxygen tension (PaO2) the most important parameter; 24% a combination of PaO2 and arterial oxygen... (More)

Background: Oxygen is liberally administered in intensive care units (ICUs). Nevertheless, ICU doctors’ preferences for supplementing oxygen are inadequately described. The aim was to identify ICU doctors’ preferences for arterial oxygenation levels in mechanically ventilated adult ICU patients. Methods: In April to August 2016, an online multiple-choice 17-part-questionnaire was distributed to 1080 ICU doctors in seven Northern European countries. Repeated reminder e-mails were sent. The study ended in October 2016. Results: The response rate was 63%. When evaluating oxygenation 52% of respondents rated arterial oxygen tension (PaO2) the most important parameter; 24% a combination of PaO2 and arterial oxygen saturation (SaO2); and 23% preferred SaO2. Increasing, decreasing or not changing a default fraction of inspired oxygen of 0.50 showed preferences for a PaO2 around 8 kPa in patients with chronic obstructive pulmonary disease, a PaO2 around 10 kPa in patients with healthy lungs, acute respiratory distress syndrome or sepsis, and a PaO2 around 12 kPa in patients with cardiac or cerebral ischaemia. Eighty per cent would accept a PaO2 of 8 kPa or lower and 77% would accept a PaO2 of 12 kPa or higher in a clinical trial of oxygenation targets. Conclusion: Intensive care unit doctors preferred PaO2 to SaO2 in monitoring oxygen treatment when peripheral oxygen saturation was not included in the question. The identification of PaO2 as the preferred target and the thorough clarification of preferences are important when ascertaining optimal oxygenation targets. In particular when designing future clinical trials of higher vs lower oxygenation targets in ICU patients.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
62
issue
10
pages
9 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85054818116
  • pmid:29926908
ISSN
0001-5172
DOI
10.1111/aas.13171
language
English
LU publication?
yes
id
fdc2bfe4-5880-4aa6-a695-983337090fa8
date added to LUP
2018-10-30 10:54:05
date last changed
2021-10-06 04:06:53
@article{fdc2bfe4-5880-4aa6-a695-983337090fa8,
  abstract     = {<p>Background: Oxygen is liberally administered in intensive care units (ICUs). Nevertheless, ICU doctors’ preferences for supplementing oxygen are inadequately described. The aim was to identify ICU doctors’ preferences for arterial oxygenation levels in mechanically ventilated adult ICU patients. Methods: In April to August 2016, an online multiple-choice 17-part-questionnaire was distributed to 1080 ICU doctors in seven Northern European countries. Repeated reminder e-mails were sent. The study ended in October 2016. Results: The response rate was 63%. When evaluating oxygenation 52% of respondents rated arterial oxygen tension (PaO<sub>2</sub>) the most important parameter; 24% a combination of PaO<sub>2</sub> and arterial oxygen saturation (SaO<sub>2</sub>); and 23% preferred SaO<sub>2</sub>. Increasing, decreasing or not changing a default fraction of inspired oxygen of 0.50 showed preferences for a PaO<sub>2</sub> around 8 kPa in patients with chronic obstructive pulmonary disease, a PaO<sub>2</sub> around 10 kPa in patients with healthy lungs, acute respiratory distress syndrome or sepsis, and a PaO<sub>2</sub> around 12 kPa in patients with cardiac or cerebral ischaemia. Eighty per cent would accept a PaO<sub>2</sub> of 8 kPa or lower and 77% would accept a PaO<sub>2</sub> of 12 kPa or higher in a clinical trial of oxygenation targets. Conclusion: Intensive care unit doctors preferred PaO<sub>2</sub> to SaO<sub>2</sub> in monitoring oxygen treatment when peripheral oxygen saturation was not included in the question. The identification of PaO<sub>2</sub> as the preferred target and the thorough clarification of preferences are important when ascertaining optimal oxygenation targets. In particular when designing future clinical trials of higher vs lower oxygenation targets in ICU patients.</p>},
  author       = {Schjørring, O. L. and Toft-Petersen, A. P. and Kusk, K. H. and Mouncey, P. and Sørensen, E. E. and Berezowicz, P. and Bestle, M. H. and Bülow, H. H. and Bundgaard, H. and Christensen, S. and Iversen, S. A. and Kirkeby-Garstad, I. and Krarup, K. B. and Kruse, M. and Laake, J. H. and Liboriussen, L. and Læbel, R. L. and Okkonen, M. and Poulsen, L. M. and Russell, L. and Sjövall, F. and Sunde, K. and Søreide, E. and Waldau, T. and Walli, A. R. and Perner, A. and Wetterslev, J. and Rasmussen, B. S.},
  issn         = {0001-5172},
  language     = {eng},
  number       = {10},
  pages        = {1443--1451},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Intensive care doctors’ preferences for arterial oxygen tension levels in mechanically ventilated patients},
  url          = {http://dx.doi.org/10.1111/aas.13171},
  doi          = {10.1111/aas.13171},
  volume       = {62},
  year         = {2018},
}