S_pO₂ values in acute medical admissions breathing air¡ªImplications for the British Thoracic Society guideline for emergency oxygen use in adult patients?

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• 作者：Gary B. Smith ; David R. Prytherch ; Duncan Watson ; Val Forde ; Alastair Windsor ; Paul E. Schmidt ; Peter I. Featherstone ; Bernie Higgins ; Paul Meredith
• 关键词：Adult ; Critical illness ; Oximetry ; Oxygen ; Therapy
• 刊名：Resuscitation
• 出版年：2012
• 出版时间：October, 2012
• 年：2012
• 卷：83
• 期：10
• 页码：1201-1205
• 全文大小：253 K

文摘

S_pO₂ is routinely used to assess the well-being of patients, but it is difficult to find an evidence-based description of its normal range. The British Thoracic Society (BTS) has published guidance for oxygen administration and recommends a target S_pO₂ of 94-98 % for most adult patients. These recommendations rely on consensus opinion and small studies using arterial blood gas measurements of saturation (S_aO₂). Using large datasets of routinely collected vital signs from four hospitals, we analysed the S_pO₂ range of 37,593 acute general medical inpatients (males: 47 % ) observed to be breathing room air. Age at admission ranged from 16 to 105 years with a mean (SD) of 64 (21) years. 19,642 admissions (52 % ) were aged <70 years. S_pO₂ ranged from 70 % to 100 % with a median (IQR) of 97 % (95-98 % ). S_pO₂ values for males and females were similar. In-hospital mortality for the study patients was 5.27 % (range 4.80-6.27 % ). Mortality (95 % CI) for patients with initial S_pO₂ values of 97 % , 96 % and 95 % was 3.65 % (3.22-4.13); 4.47 % (3.99-5.00); and 5.67 % (5.03-6.38), respectively. Additional analyses of S_pO₂ values for 37,299 medical admissions aged ¡Ý18 years provided results that were distinctly different to those upon which the current BTS guidelines based their definition of normality. Our findings suggest that the BTS should consider changing its target saturation for actively treated patients not at risk of hypercapnic respiratory failure to 96-98 % .