Hyperoxemia in Mechanically Ventilated, Critically Ill Subjects: Incidence and Related Factors.
BACKGROUND: Excessive supplemental oxygen causes injurious hyperoxemia. Before establishing the best PaO2 targets for mechanically ventilated patients, it is important to understand the incidence of hyperoxemia and related factors. We investigated oxygenation in mechanically ventilated subjects in o...
| Publicado en: | Respiratory Care Vol. 60; no. 3; pp. 335 - 341 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Mar2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103766942&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103766942 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Mar2015 vid: 60 iid: 3 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 103766942 101303145 10.4187/respcare.03451 103766942 ppf: 335 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Hyperoxemia in Mechanically Ventilated, Critically Ill Subjects: Incidence and Related Factors. aug: au: Taiga Itagaki Yuuki Nakano Nao Okuda Masayo Izawa Mutsuo Onodera Hideaki Imanaka Masaji Nishimura affil: Department of Emergency and Critical Care Medicine, University of Tokushima Graduate School, Tokushima, Japan sug: subj: Respiration, Artificial Adverse Effects Critically Ill Patients Heart Failure Human Retrospective Design Record Review Odds Ratio Confidence Intervals APACHE (Acute Physiology and Chronic Health Evaluation) Questionnaires Descriptive Statistics Data Analysis Software Male Female Middle Age Aged Adult Prospective Studies Middle Aged: 45-64 years Aged: 65+ years Adult: 19-44 years Male Female ab: BACKGROUND: Excessive supplemental oxygen causes injurious hyperoxemia. Before establishing the best PaO2 targets for mechanically ventilated patients, it is important to understand the incidence of hyperoxemia and related factors. We investigated oxygenation in mechanically ventilated subjects in our ICU and evaluated factors related to hyperoxemia (PaO2 > 120 mm Hg) at 48 h after initiation of mechanical ventilation. METHODS: We retrospectively reviewed the medical records of patients admitted to our ICU from January 2010 to May 2013. Inclusion criteria were 15 y of age or older and administration of mechanical ventilation for > 48 h. Patients at risk of imminent death on admission or who had received noninvasive ventilation were excluded. We collected subject demographics, reasons for mechanical ventilation, and during mechanical ventilation, we collected arterial blood gas data and ventilator settings on the first day of intubation (T1), 48 h after initiation of mechanical ventilation (T2), and on the day of extubation (T3). Multivariable logistic regression analysis was performed to clarify independent variables related to hyperoxemia at T2. RESULTS: For the study period, data for 328 subjects were analyzed. PaO2 statistically significantly increased over time to 90 (interquartile range of 74 –109) mm Hg at T1, 105 (89 –120) mm Hg at T2, and 103 (91–119) mm Hg at T3 (P < .001), coincident with decreases in FIO2 of 0.4 (0.3– 0.5) at T1, 0.3 (0.3– 0.4) at T2, and 0.3 (0.3– 0.35) at T3 (P < .001). Hyperoxemia occurred in 15.6% (T1), 25.3% (T2), and 22.4% (T3) of subjects. Multivariable logistic regression analysis revealed that hyperoxemia was independently associated with age of < 40 y (odds ratio 2.6, 95% CI 1.1– 6.0), Acute Physiology and Chronic Health Evaluation II scores of ≥ 30 (odds ratio 0.53, 95% CI 0.3–1.0), and decompensated heart failure (odds ratio 1.9, 95% CI 1.1 to 3.5). CONCLUSIONS: During mechanical ventilation of critically ill subjects, PaO2 increased, and FIO2 decreased. One in 4 subjects were hyperoxemic at T2, and hyperoxemia persisted until T3. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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