Intensive Care Nursing/Oxygen- friend or foe?

Any sign of shortness of breath, chest pain or feeling of unwell- oxygen will likely be provided as one of the first interventions by health professionals. In the Intensive Care speciality, questions remain with setting safe oxygen parameters, especially difficult with complex mechanical ventilation:

Is oxygen treatment safe? Its classified as a drug, how often is it prescribed? Do we need to aim for normal for ICU patients or accept lower levels? What is considered a safe level? What is the impact of oxygen on the inflammatory process? Time for permissive hypoxaemia and target oxygen levels?

"Respiratory evidence focuses on volutrauma, barotrauma and biotrauma but the effects of high oxygen and hyperoxemia seem to have been forgotten" (Capellier, G. & Panwar, R, 2013).

The article raises some interesting discussion, take some of these concepts by the authors and discuss with nursing and medical colleagues to see what the concept of oxygen is in your clinical environment.

Readings

Heffner, J. E. (2013). The story of oxygen. Respiratory Care, 58(1), 18-30. doi:10.4187/respcare.01831

Capellier, G., & Panwar, R. (2012). [http://www.cicm.org.au/journal/2011/september/ccr_13_3_010911-139.pdf Is it time for permissive hypoxaemia in the intensive care unit?] Critical Care and Resuscitation, 14(1), 139-141

Kallet, R. H., & Matthay, M. A. (2013). Hyperoxic acute lung. Respiratory Care, 58(1), 123-140. doi:10.4187/respcare.01963