Oxygenation target in acute respiratory distress syndrome
Determining oxygenation targets in acute respiratory distress syndrome (ARDS) remains a challenge. Although oxygenation targets have been used since ARDS was first described, they have not been investigated in detail. However, recent retrospective and prospective trials have evaluated the optimal ox...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | Journal of Intensive Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667100X23000221 |
| _version_ | 1827895774193647616 |
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| author | Gilles Capellier Loic Barrot Hadrien Winizewski |
| author_facet | Gilles Capellier Loic Barrot Hadrien Winizewski |
| author_sort | Gilles Capellier |
| collection | DOAJ |
| description | Determining oxygenation targets in acute respiratory distress syndrome (ARDS) remains a challenge. Although oxygenation targets have been used since ARDS was first described, they have not been investigated in detail. However, recent retrospective and prospective trials have evaluated the optimal oxygenation threshold in patients admitted to the general intensive care unit. In view of the lack of prospective data, clinicians continue to rely on data from the few available trials to identify the optimal oxygenation strategy. Assessment of the cost-benefit ratio of the fraction of inspired oxygen (FiO2) to the partial pressure of oxygen in the arterial blood (PaO2) is an additional challenge. A high FiO2 has been found to be responsible for respiratory failure and deaths in numerous animal models. Low and high PaO2 values have also been demonstrated to be potential risk factors in experimental and clinical situations. The findings from this literature review suggest that PaO2 values ranging between 80 mmHg and 90 mmHg are acceptable in patients with ARDS. The costs of rescue maneuvers needed to reach these targets have been discussed. Several recent papers have highlighted the risk of disagreement between arterial oxygen saturation (SaO2) and peripheral oxygen saturation (SpO2) values. In order to avoid discrepancies and hidden hypoxemia, SpO2 readings need to be compared with those of SaO2. Higher SpO2 values may be needed to achieve the recommended PaO2 and SaO2 values. |
| first_indexed | 2024-03-12T22:25:34Z |
| format | Article |
| id | doaj.art-4faea633cab040b5af8a8ff15d4a2f61 |
| institution | Directory Open Access Journal |
| issn | 2667-100X |
| language | English |
| last_indexed | 2024-03-12T22:25:34Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Intensive Medicine |
| spelling | doaj.art-4faea633cab040b5af8a8ff15d4a2f612023-07-22T04:52:59ZengElsevierJournal of Intensive Medicine2667-100X2023-07-0133220227Oxygenation target in acute respiratory distress syndromeGilles Capellier0Loic Barrot1Hadrien Winizewski2Réanimation Médicale, CHU Jean Minjoz, Besançon 25000, France; Department of Health, Monash University, Melbourne 3800, Australia; Equipe d'accueil EA 3920, Université de Franche Comte, Besançon 25000, France; Corresponding author: Gilles Capellier, Réanimation Médicale, CHU Jean Minjoz, Besançon 25000, France.Réanimation Médicale, CHU Jean Minjoz, Besançon 25000, France; Département d'Anesthésie-Réanimation, CHU Jan Minjoz, Besançon 25000, FranceRéanimation Médicale, CHU Jean Minjoz, Besançon 25000, France; Equipe d'accueil EA 3920, Université de Franche Comte, Besançon 25000, FranceDetermining oxygenation targets in acute respiratory distress syndrome (ARDS) remains a challenge. Although oxygenation targets have been used since ARDS was first described, they have not been investigated in detail. However, recent retrospective and prospective trials have evaluated the optimal oxygenation threshold in patients admitted to the general intensive care unit. In view of the lack of prospective data, clinicians continue to rely on data from the few available trials to identify the optimal oxygenation strategy. Assessment of the cost-benefit ratio of the fraction of inspired oxygen (FiO2) to the partial pressure of oxygen in the arterial blood (PaO2) is an additional challenge. A high FiO2 has been found to be responsible for respiratory failure and deaths in numerous animal models. Low and high PaO2 values have also been demonstrated to be potential risk factors in experimental and clinical situations. The findings from this literature review suggest that PaO2 values ranging between 80 mmHg and 90 mmHg are acceptable in patients with ARDS. The costs of rescue maneuvers needed to reach these targets have been discussed. Several recent papers have highlighted the risk of disagreement between arterial oxygen saturation (SaO2) and peripheral oxygen saturation (SpO2) values. In order to avoid discrepancies and hidden hypoxemia, SpO2 readings need to be compared with those of SaO2. Higher SpO2 values may be needed to achieve the recommended PaO2 and SaO2 values.http://www.sciencedirect.com/science/article/pii/S2667100X23000221OxygenOxygenationAcute respiratory distress syndromeFraction of inspired oxygen (FiO2)Arterial oxygen saturationPeripheral oxygen saturation (SpO2) |
| spellingShingle | Gilles Capellier Loic Barrot Hadrien Winizewski Oxygenation target in acute respiratory distress syndrome Journal of Intensive Medicine Oxygen Oxygenation Acute respiratory distress syndrome Fraction of inspired oxygen (FiO2) Arterial oxygen saturation Peripheral oxygen saturation (SpO2) |
| title | Oxygenation target in acute respiratory distress syndrome |
| title_full | Oxygenation target in acute respiratory distress syndrome |
| title_fullStr | Oxygenation target in acute respiratory distress syndrome |
| title_full_unstemmed | Oxygenation target in acute respiratory distress syndrome |
| title_short | Oxygenation target in acute respiratory distress syndrome |
| title_sort | oxygenation target in acute respiratory distress syndrome |
| topic | Oxygen Oxygenation Acute respiratory distress syndrome Fraction of inspired oxygen (FiO2) Arterial oxygen saturation Peripheral oxygen saturation (SpO2) |
| url | http://www.sciencedirect.com/science/article/pii/S2667100X23000221 |
| work_keys_str_mv | AT gillescapellier oxygenationtargetinacuterespiratorydistresssyndrome AT loicbarrot oxygenationtargetinacuterespiratorydistresssyndrome AT hadrienwinizewski oxygenationtargetinacuterespiratorydistresssyndrome |