Hyperoxemia in the Intensive Care Unit(ICU)

Overview

In our study, to research the prevalence of hyperoxemia in adult patients treated in the intensive care unit (ICU) and its relationship with clinical outcomes. This single-center, observational study included 260 consecutive patients aged 18-85 years who received oxygen therapy in the ICU for respiratory failure. Hyperoxia was defined as SpO₂\>96% and PaO₂\>100 mmHg in the first 24 hours. Patients were divided into normoxic and hyperoxic groups, and demographic characteristics, comorbidities, ICU admission scores, mechanical ventilation requirements, ICU and hospital length of stay, and in-hospital mortality were compared.The mean age of the patients was 69.9±15.4 years, and 55.8% were male. According to SpO₂-PaO₂ criteria, hyperoxia was detected in 59.6% (n=155) of patients and normoxia in 40.4% (n=105). The groups were similar in terms of age, gender, BMI, and APACHE II score. The SOFA score and admission GCS were lower in the hyperoxic group, and the duration of mechanical ventilation, ICU, and hospital stays were significantly longer (p\<0.01 for all). In-hospital mortality was significantly higher in the hyperoxic group (82.5% vs. 50.4%; p\<0.001). In our study, hyperoxia developed in approximately two-thirds of the patients in the ICU, and hyperoxia was associated with increased mortality and length of stay. These results highlight the importance of avoiding hyperoxia when titrating oxygen therapy in critically ill patients.

In this study; It was aimed to examine the effects of non-invasive and invasive oxygen therapy on hyperoxemia in patients treated in the intensive care unit of Trakya University Hospital.Patients aged 18-85, who received non-invasive or invasive oxygen therapy as indicated due to respiratory failure and who were detected to have hyperoxia in the first 24 hours of treatment, were included in the study. SpO2 \> 96% and PaO2 \> 100 were considered hyperoxia. HFNO, CPAP and simple face mask oxygen therapy methods were used as noninvasive respiratory support methods. Patients who stayed in the intensive care unit for less than 24 hours, patients with suspected brain death, and patients with suspected pregnancy were excluded from the study. The patients' respiratory failure was treated as indicated. All patients were evaluated according to their age, gender, whether they were intubated during the ICU stay, mechanical ventilation duration if intubated, on which day they were extubated, duration of ICU stay, highest PaO2 values in the first 24 hours of ICU stay, hourly oxygen saturation levels and mortality rates. recorded from the patient file. The findings were compared with each other and it was aimed to determine which treatment methods caused more hyperoxia. In the study, it was found that 40.4% of all patients were normoxic, 59.6% were hyperoxic, 42.5% of those receiving oxygen mask therapy, 60% of those receiving HFNO therapy, 63.4% of those receiving CPAP therapy and It was found that 63.2% of those receiving IMV treatment were in the hyperoxic group. When the transition from respiratory therapy to IMV is examined; While the rate of switching from oxygen mask therapy to IMV was found to be similar in both groups, the rate of switching from HFNO and CPAP treatments to IMV was found to be statistically significantly higher in the Hyperoxia group than in the Normoxative group. In conclusion; The fact that hyperoxemia has both positive and negative aspects both in the literature and in our study necessitates the need for studies on this subject to be carried out in isolation and with a higher number of cases. Such studies will enable better evaluation of hyperoxemia in the future.