Abstract
Hyperoxia, or excess oxygen supplementation, prevails in the intensive care unit (ICU)
without a beneficial effect and, in some instances, may cause harm. Recent interest
and surge in clinical studies in mechanically ventilated critically ill patients has
brought this to the attention of clinicians and researchers. Hyperoxia can cause alveolar
injury, pulmonary edema, and subsequent systemic inflammatory response and is known
to augment ventilator-associated lung injury. Liberal oxygenation practices are also
associated with increased mortality in subsets of critically ill patients with post–cardiac
arrest, stroke, and traumatic brain injury. Most clinicians agree that oxygen titration
should be done and, with appropriate safeguards, lower oxygenation targets may be
acceptable and possibly beneficial in many critically ill patients. However, this
problem is often overlooked. The use of periodic reminders and decision support may
facilitate implementation of more precise oxygen titration at the bedside of critically
ill patients. For implementing practice change, studies involving education and guidance
of all health care staff involved in oxygen management are critical.
Keywords
oxygen supplementation - hyperoxia - oxygen toxicity - oxygen titration