open access

Vol 48, No 3 (2016)
Original and clinical articles
Published online: 2016-05-18
Submitted: 2015-10-02
Accepted: 2016-01-09
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Efficiency of goal-directed oxygen delivery in ICU patients

Sebastien Jochmans, Ly-Van Phach Vong, Nathalie Rolin, Oumar Sy, Jonathan Chelly, Olivier Ellrodt, Jean-Emmanuel Alphonsine, Jean Serbource-Goguel, Razach Idriss Abdallah, Claire-Marie Weyer, Mehran Monchi, Christophe Vinsonneau
DOI: 10.5603/AIT.a2016.0027
·
Anaesthesiol Intensive Ther 2016;48(3):151-157.

open access

Vol 48, No 3 (2016)
Original and clinical articles
Published online: 2016-05-18
Submitted: 2015-10-02
Accepted: 2016-01-09

Abstract

BACKGROUND: Current clinical practice guidelines promote a goal-directed approach for oxygen delivery with respect to SpO2 objectives. We evaluated the efficiency of a strategy based on goal-directed O2 delivery in the ICU.

METHODS: A group of 30 patients (Group 1) with a proven history of chronic obstructive pulmonary disease suffering from acute hypercarbic exacerbation was compared to 2 other groups of patients admitted for acute respiratory failure with no history of pulmonary disease: 30 patients requiring oxygen supply and/or non-invasive ventilation (Group 2) and 30 requiring invasive ventilation (Group 3). The delivery of oxygen was based on SpO2 measurement: 88−94% for Group 1 and 90−96% for others. The time spent with an SpO2 below, within and above the prescribed limits was collected.

RESULTS: The mean time spent within the prescribed range was for Groups 1, 2 and 3, respectively as follows: 61.9% [60.5−63.2], 63.7% [62.3−65] and 56.4% [55.3−57.6] (P < 0.001 for each group). A history of chronic obstructive pulmonary disease was not correlated with better results (P = 0.11), while invasive ventilation was related to the time spent out of the prescribed range (P < 0.001; OR 1.3 [1.22−1.28]) especially in hyperoxaemia (40.7% [39.6−41.8] P < 0.001). Efficiency seems unrelated to nursing workload or night team exhaustion (r = −0.09, P = 0.77).

CONCLUSIONS: Goal-directed oxygen delivery based on SpO2 objectives in ICU patients ensures that in only approximately 64% of the time, SpO2 stays within the prescribed range.

Abstract

BACKGROUND: Current clinical practice guidelines promote a goal-directed approach for oxygen delivery with respect to SpO2 objectives. We evaluated the efficiency of a strategy based on goal-directed O2 delivery in the ICU.

METHODS: A group of 30 patients (Group 1) with a proven history of chronic obstructive pulmonary disease suffering from acute hypercarbic exacerbation was compared to 2 other groups of patients admitted for acute respiratory failure with no history of pulmonary disease: 30 patients requiring oxygen supply and/or non-invasive ventilation (Group 2) and 30 requiring invasive ventilation (Group 3). The delivery of oxygen was based on SpO2 measurement: 88−94% for Group 1 and 90−96% for others. The time spent with an SpO2 below, within and above the prescribed limits was collected.

RESULTS: The mean time spent within the prescribed range was for Groups 1, 2 and 3, respectively as follows: 61.9% [60.5−63.2], 63.7% [62.3−65] and 56.4% [55.3−57.6] (P < 0.001 for each group). A history of chronic obstructive pulmonary disease was not correlated with better results (P = 0.11), while invasive ventilation was related to the time spent out of the prescribed range (P < 0.001; OR 1.3 [1.22−1.28]) especially in hyperoxaemia (40.7% [39.6−41.8] P < 0.001). Efficiency seems unrelated to nursing workload or night team exhaustion (r = −0.09, P = 0.77).

CONCLUSIONS: Goal-directed oxygen delivery based on SpO2 objectives in ICU patients ensures that in only approximately 64% of the time, SpO2 stays within the prescribed range.

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Keywords

hyperoxaemia; hypoxaemia; pulse oximetry; oxygen therapy; mechanical ventilation; nurse protocol; goal-oriented therapy

About this article
Title

Efficiency of goal-directed oxygen delivery in ICU patients

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 48, No 3 (2016)

Pages

151-157

Published online

2016-05-18

DOI

10.5603/AIT.a2016.0027

Bibliographic record

Anaesthesiol Intensive Ther 2016;48(3):151-157.

Keywords

hyperoxaemia
hypoxaemia
pulse oximetry
oxygen therapy
mechanical ventilation
nurse protocol
goal-oriented therapy

Authors

Sebastien Jochmans
Ly-Van Phach Vong
Nathalie Rolin
Oumar Sy
Jonathan Chelly
Olivier Ellrodt
Jean-Emmanuel Alphonsine
Jean Serbource-Goguel
Razach Idriss Abdallah
Claire-Marie Weyer
Mehran Monchi
Christophe Vinsonneau

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