Evidence for Oxygen Use in the Hospitalized Patient: Is More Really the Enemy of Good?
Evidence for Oxygen Use in the Hospitalized Patient: Is More Really the Enemy of Good?
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DOI：
10.4187/respcare.02677
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发表时间：
2013-10-01
期刊：
影响因子：
2.5
通讯作者：
Blakeman, Thomas C.
中科院分区：
文献类型：
--
作者：
Blakeman, Thomas C.
氧气可以说是现代医疗保健中最常用的药物之一，但通常由护理人员自行决定给予患者，缺乏关于其疗效或安全性的证据。尽管在医院环境中，氧气用于各种医疗条件，但已发表的文献支持使用氧气来逆转低氧血症，用于创伤性脑损伤和出血性休克的创伤患者，用于心脏骤停期间的复苏，以及用于一氧化碳中毒。除一氧化碳中毒（100%氧气）、ARDS（88-95%）、高碳酸血症风险人群（S-pO 2 88- 92%）和早产儿（S-pO 2 88 - 94%）外，应滴定氧气以使S-pO 2达到94- 98%。用于其他需要吸氧的情况的证据依赖于轶事经验、病例报告或小型、动力不足的研究。在这些疗效和/或安全性不确定的情况下使用氧气的结论需要大型随机对照临床试验。
Oxygen in arguably one of the most frequently utilized drugs in modern healthcare, but is often administered to patients at caregivers' discretion with scant evidence as to its efficacy or safety. Although oxygen is administered for varied medical conditions in the hospital setting, published literature supports the use of oxygen to reverse hypoxemia, for trauma victims with traumatic brain injury and hemorrhagic shock, for resuscitation during cardiac arrest, and for carbon monoxide poisoning. Oxygen should be titrated to target an S-pO2 of 94-98%, except with carbon monoxide poisoning (100% oxygen), ARDS (88-95%), those at risk for hypercapnia (S-pO2 88-92%), and premature infants (S-pO2 88-94%). Evidence for use with other conditions for which oxygen is administered relies on anecdotal experiences, case reports, or small, underpowered studies. Definitive conclusions for oxygen use in these conditions where efficacy and/or safety are uncertain will require large randomized controlled clinical trials.