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

2018; Wiley; Volume: 62; Issue: 10 Linguagem: Inglês

10.1111/aas.13171

1399-6576

Olav L. Schjørring, Anne Pernille Toft‐Petersen, Kathrine Hoffmann Kusk, Paul Mouncey, Erik Elgaard Sørensen, P S Berezowicz, Morten H. Bestle, Hans‐Henrik Bülow, Henning Bundgaard, Steffen Christensen, Susanne Iversen, Idar Kirkeby‐Garstad, Kenneth B Krarup, Michelle Kruse, Jon Henrik Laake, Lone Liboriussen, R. L. Læbel, Marjatta Okkonen, Lone Musaeus Poulsen, Lene Russell, Fredrik Sjövall, Kjetil Sunde, Eldar Søreide, Tina Waldau, Akil Walli, Anders Perner, Jørn Wetterslev, Bodil Steen Rasmussen,

Cardiac Arrest and Resuscitation

Background Oxygen is liberally administered in intensive care units ( ICU s). 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 2 ) the most important parameter; 24% a combination of PaO 2 and arterial oxygen saturation (SaO 2 ); and 23% preferred SaO 2 . Increasing, decreasing or not changing a default fraction of inspired oxygen of 0.50 showed preferences for a PaO 2 around 8 kP a in patients with chronic obstructive pulmonary disease, a PaO 2 around 10 kP a in patients with healthy lungs, acute respiratory distress syndrome or sepsis, and a PaO 2 around 12 kP a in patients with cardiac or cerebral ischaemia. Eighty per cent would accept a PaO 2 of 8 kP a or lower and 77% would accept a PaO 2 of 12 kP a or higher in a clinical trial of oxygenation targets. Conclusion Intensive care unit doctors preferred PaO 2 to SaO 2 in monitoring oxygen treatment when peripheral oxygen saturation was not included in the question. The identification of PaO 2 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.