Hello and welcome to our next episode – we hope you enjoy it. This episode concentrates on hyperoxia – the delivery of lots (often too much) oxygen and the harms it may cause our patients. We both had colds – many apologies for the blocked noses and many sniffs!
We hope you find it useful.
To follow: Dr Matt Thomas from the Great Western Air Ambulance discussing his groups work around reducing hyperoxia post-rosc.
Further reading:
- https://www.brit-thoracic.org.uk/guidelines-and-quality-standards/
- Cornet AD, Kooter AJ, Peters MJL, Smulders YM. The potential harm of oxygen therapy in medical emergencies. Crit Care. 2013 Apr 11;17(2):313.
- Rincon F, Kang J, Maltenfort M, Vibbert M, Urtecho J, Athar MK, et al. Association Between Hyperoxia and Mortality After Stroke. Crit Care Med. 2014 Feb;42(2):387–96.
- Stub D, Smith K, Bernard S, Bray J, Stephenson M, Cameron P, et al. A randomized controlled trial of oxygen therapy inacute myocardial infarction Air Verses Oxygen InmyocarDial infarction study (AVOID Study). American Heart Journal. Mosby, Inc; 2012 Mar 1;163(3):339–345.e1. 3. Asfar P, Singer M, Radermacher P. Understanding the benefits and harms of oxygen therapy. Intensive Care Med. 2015 Jan 30.
- Calzia E, Asfar P, Hauser B, Matejovic M, Ballestra C, Radermacher P, et al. Hyperoxia may be beneficial. Crit Care Med. 2010 Oct;38:S559–68.
- Asfar P, Calzia E, Huber-Lang M, Ignatius A, Radermacher P. Hyperoxia during septic shock–Dr. Jekyll or Mr. Hyde? Shock. 2011 Nov 21;37(1):122–3.
- Cornet AD, Kooter AJ, Peters MJL, Smulders YM. The potential harm of oxygen therapy in medical emergencies. Crit Care. 2013 Apr 11;17(2):313.
- Ligtenberg JJM, Stolmeijer R, Broekema JJ, Maaten ter JC, Zijlstra JG. A little less saturation? Crit Care. 2013 Jun 12;17(3):439.
How to cite this podcast:
Nutbeam T, Bosanko C. Hyperoxia. PHEMCAST. 2015 [cite Date Accessed]. Available from: http://www.phemcast.co.uk
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Great stuff, thank you – something I’d been pondering at work for a while. It’s worth highlighting that while hyperoxia may cause harm, hypoxia is associated with worse outcome in brain injury (only trumped by hypotension). See Brain Trauma Foundation Guidelines for 2007 – getting rather old now, but still. If I injured my brain I think I’d have some oxygen, please – I’d chance the potential harm of hyperoxia to make as sure as possible that I didn’t suffer any spells of hypoxia, until transport monitoring is infallible.
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Couldn’t agree more. There is a fine balance that we need to get right. Oxygen is a drug which should be appropriately used and easy (lazy!) care – leaving them on an FiO2 of 1 is probably not the right thing for everybody – we’re working on a podcast now on patients which require oxygen and how to deliver it! Thanks for your comment!
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Thanks for your podcast. Just highlights again that resuscitation is an intelligent process and that one size doesn’t fit all.
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