1. Are we giving too much oxygen to patients at risk of hypercapnia? Real world data from a large teaching hospital.
- Author
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O'Driscoll BR and Bakerly ND
- Abstract
Introduction: Oxygen guidelines recommend a target saturation range (SpO
2 range) of 88-92 % for patients at risk of hypercapnia. Saturations <88 % and saturations >92 % whilst using supplemental oxygen are associated with increased mortality., Methods: We audited SpO2 observations of all patients with a prescribed target range of 88-92 % at one hospital over a four-year period., Results: Of 1,045,958 observations from patients with an oxygen prescription, 107,724 (10.3 %) had a target range of 88-92 % (at risk of hypercapnia). 26,668 of these observations (24.8 %) involved oxygen use. 89.6 % of the SpO2 observations with target SpO2 range 88-92 % were satisfactory with SpO2 ≥88 % breathing air or SpO2 88-92 % breathing oxygen. However, 1.2 % of SpO2 observations for these patients were too low (<88 %). This was commoner in observations involving use of supplemental oxygen (2.2 %) compared with observations on air (0.9 %). Of the SpO2 observations with target SpO2 range 88-92 % which were recorded whilst the patient was receiving supplemental oxygen therapy, 9870 had SpO2 >92 % (over-oxygenated). This represented 9.2 % of all observations for patients with a target range of 88-92 % and 37.0 % of the 26,668 observations involving use of oxygen for these patients. Compared with nasal cannulae, SpO2 observations involving use of simple masks, Venturi masks and humidified oxygen were more commonly outside of the target range., Summary: We found that excessive oxygen administration was much commoner than insufficient oxygen therapy for hospital patients at risk of hypercapnia. Excessive oxygen use implies an increased risk of harm to these patients, increased cost, and potentially delayed discharges., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier Ltd.)- Published
- 2025
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