Oxygen therapy: professional compliance with national guidelines

Nippers, Ingrid; Sutton, Andrew

doi:10.12968/bjon.2014.23.7.382

Cited by 10 publications

(11 citation statements)

References 16 publications

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“…Oxygen therapy is essential in the treatment of patients with respiratory failure. However, studies have observed poor compliance of health professionals with international guidelines concerning the use of oxygen therapy in the acute setting [5]. Potential risks associated with the available oxygen delivery systems are hypoxemia or hyperoxia-induced hypercapnia.…”

Section: Discussionmentioning

confidence: 99%

“…In order to avoid these complications, current guidelines suggest monitoring of oxygen delivery to target oxygen saturation (SpO 2 ) of 88–92% for hypercapnic patients and 94–98% for normocapnic subjects with acute respiratory failure [1, 2]. However, available constant flow devices do not have the ability to titrate oxygen flow according to patients corresponding SpO 2 , while studies have shown poor compliance of health professional with international guidelines [5].…”

Section: Introductionmentioning

confidence: 99%

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Automated Oxygen Delivery in Hospitalized Patients with Acute Respiratory Failure: A Pilot Study

Malli

Boutlas

Lioufas

et al. 2019

Canadian Respiratory Journal

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Background and Objectives. Despite its’ proven benefits, oxygen therapy may be complicated with potential adverse events such as hypoxemia or hyperoxia-driven hypercapnia. Automated oxygen delivery systems may aid in avoiding these complications. The scope of the present study is to test the efficacy and safety of a new automated oxygen delivery device. Methods. This study included 23 patients with acute respiratory failure (ARF) hospitalized in the Respiratory Medicine Department of the University Hospital of Larissa. Both patients with purely hypoxemic or hypercapnic ARF were included. Automated oxygen administration was performed with Digital Oxygen Therapy, a new closed-loop system designed to automatically adjust oxygen flow according to target oxygen saturation (SpO2) of 88–92% for hypercapnic patients and 92–96% for purely hypoxemic patients with ARF. The device was applied for 4 hours. Arterial blood gas analysis was performed at 1 hour and 3 hours following the device application. Results. Mean age was 72.91 ± 13.91 years. Twelve patients were male, and 11 were female. The majority of patients suffered from hypercapnic respiratory failure (n=13, 56.5%). At 1 hour and 3 hours, SpO2 and PaO2 displayed excellent correlation (p<0.001, r = 0.943, and p<0.001, r = 0.954, respectively). We did not observe any adverse events associated with the device. Conclusions. Our results indicate that automated oxygen treatment is feasible and safe in hospitalized patients with acute respiratory failure. Further studies are required in order to assess the long-term effects of automated oxygen delivery systems.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Automated Oxygen Delivery in Hospitalized Patients with Acute Respiratory Failure: A Pilot Study

Malli

Boutlas

Lioufas

et al. 2019

Canadian Respiratory Journal

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“…Despite extensive literature about the adverse events of inadequate use of oxygen, this therapy is still poorly prescribed and junior doctors poorly understand the effects and dangers of oxygen [18][19][20]. Changing clinical practice in response to research data (knowledge translation or implementation) is difficult in many areas of medicine, resulting in excess morbidity and mortality and significant additional financial costs [14].…”

Section: Discussionmentioning

confidence: 99%

Automaticversusmanual oxygen administration in the emergency department

et al. 2017

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Oxygen is commonly administered in hospitals, with poor adherence to treatment recommendations.We conducted a multicentre randomised controlled study in patients admitted to the emergency department requiring O ≥3 L·min Patients were randomised to automated closed-loop or manual O titration during 3 h. Patients were stratified according to arterial carbon dioxide tension ( ) (hypoxaemic ≤45 mmHg; or hypercapnic >45-≤55 mmHg) and study centre. Arterial oxygen saturation measured by pulse oximetry ( ) goals were 92-96% for hypoxaemic, or 88-92% for hypercapnic patients. Primary outcome was % time within target. Secondary endpoints were hypoxaemia and hyperoxia prevalence, O weaning, O duration and hospital length of stay.187 patients were randomised (93 automated, 94 manual) and baseline characteristics were similar between the groups. Time within the target was higher under automated titration (81±21% 51±30%, p<0.001). Time with hypoxaemia (3±9% 5±12%, p=0.04) and hyperoxia under O (4±9% 22±30%, p<0.001) were lower with automated titration. O could be weaned at the end of the study in 14.1% 4.3% patients in the automated and manual titration group, respectively (p<0.001). O duration during the hospital stay was significantly reduced (5.6±5.4 7.1±6.3 days, p=0.002).Automated O titration in the emergency department improved oxygenation parameters and adherence to guidelines, with potential clinical benefits.

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“…In addition, the move toward comprehensively prescribing oxygen should provide a simple framework to guide staff caring for the patient. Perhaps paramount, however, is the education of health care professionals, particularly the doctors, nurses, and paramedics who are responsible for administering oxygen therapy to patients with COPD 95. Hospitals should institute local policies to improve education and practice, and these should be subject to rigorous audit and reevaluation 55…”

Section: Current Practice and Strategies For Changing Behaviormentioning

confidence: 99%

Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease

Brill¹,

Wedzicha²

2014

COPD

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Acute exacerbations of chronic obstructive pulmonary disease (COPD) are important events in the history of this debilitating lung condition. Associated health care utilization and morbidity are high, and many patients require supplemental oxygen or ventilatory support. The last 2 decades have seen a substantial increase in our understanding of the best way to manage the respiratory failure suffered by many patients during this high-risk period. This review article examines the evidence underlying supplemental oxygen therapy during exacerbations of COPD. We first discuss the epidemiology and pathophysiology of respiratory failure in COPD during exacerbations. The rationale and evidence underlying oxygen therapy, including the risks when administered inappropriately, are then discussed, along with further strategies for ventilatory support. We also review current recommendations for best practice, including methods for improving oxygen provision in the future.

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Oxygen therapy: professional compliance with national guidelines

Cited by 10 publications

References 16 publications

Automated Oxygen Delivery in Hospitalized Patients with Acute Respiratory Failure: A Pilot Study

Automated Oxygen Delivery in Hospitalized Patients with Acute Respiratory Failure: A Pilot Study

Automaticversusmanual oxygen administration in the emergency department

Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease

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