Attitudes of Dutch intensive care unit clinicians towards oxygen therapy

C.C.A. Grim*, A.D. Cornet, A. Kroner, A.J. Meinders, A.J.B.W. Brouwers, A.C. Reidinga, D.J. van Westerloo, D.C.J.J. Bergmans, D. Gommers, D. Versluis, D. Weller, E.C. Boerma, E. van Driel, E. de Jonge, F.J. Schoonderbeek, H.J.F. Helmerhorst, H.G. Jongsma-van Netten, J. Weenink, K.J. Woittiez, K.S. SimonsL. van Welie, M. Petjak, M.J. Sigtermans, M. van der Woude, O.L. Cremer, P. Bijlstra, P. van der Heiden, R.K.L. So, R. Vink, T. Jansen, W. de Ruijter, ATONIC Study Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Over the last decade, there has been an increasing awareness for the potential harm of the administration of too much oxygen. We aimed to describe self-reported attitudes towards oxygen therapy by clinicians from a large representative sample of intensive care units (ICUs) in the Netherlands.Methods: In April 2019, 36 ICUs in the Netherlands were approached and asked to send out a questionnaire (59 questions) to their nursing and medical staff (ICU clinicians) eliciting self-reported behaviour and attitudes towards oxygen therapy in general and in specific ICU case scenarios.Results: In total, 1361 ICU clinicians (71% nurses, 24% physicians) from 28 ICUs returned the questionnaire. Of responding ICU clinicians, 64% considered oxygen-induced lung injury to be a major concern. The majority of respondents considered a partial pressure of oxygen (PaO2) of 6-10 kPa (45-75 mmHg) and an arterial saturation (SaO(2)) of 85-90% as acceptable for 15 minutes, and a PaO2 7-To kPa (53-75 mmHg) and SaO(2) 90-95% as acceptable for 24-48 hours in an acute respiratory distress syndrome (ARDS) patient. In most case scenarios, respondents reported not to change the fraction of inspired oxygen (FiO(2)) if SaO(2) was 90-95% or PaO2 was 12 kPa (90 mmHg).Conclusion: A representative sample of ICU clinicians from the Netherlands were concerned about oxygen-induced lung injury, and reported that they preferred PaO2 and SaO(2) targets in the lower physiological range and would adjust ventilation settings accordingly.
Original languageEnglish
Pages (from-to)167-174
Number of pages8
JournalNetherlands Journal of Medicine
Volume78
Issue number4
Publication statusPublished - 1 Jul 2020

Keywords

  • conservative oxygenation
  • intensive care unit
  • mechanical ventilation
  • mortality
  • opinion
  • outcomes
  • oxygen therapy
  • questionnaire
  • respiratory-distress-syndrome
  • self-reported practice
  • survey
  • tidal volumes
  • ventilation
  • Conservative oxygenation
  • MORTALITY
  • SELF-REPORTED PRACTICE
  • TIDAL VOLUMES
  • RESPIRATORY-DISTRESS-SYNDROME
  • VENTILATION
  • OUTCOMES
  • OPINION

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