Chronic Disease

New Guidelines for Supplemental Oxygen in Acutely Ill Adults Released

An international expert panel has released new guidelines for the use of oxygen therapy for patients with acute illness.1

 

They based the recommendations on a recent systematic review and meta-analysis of randomized controlled trials of acutely ill adults treated with liberal vs conservative oxygen therapy.2

 

Using the evidence from the previous study, the panel aimed to “promptly and transparently translate potentially practice-changing evidence to usable recommendations for clinicians and patients.”

 

Among the recommendations:

  • For patients receiving oxygen therapy, aim for peripheral capillary oxygen saturation (SpO2) of ≤96% (strong recommendation)
  • For patients with acute myocardial infarction or stroke, do not initiate oxygen therapy in patients with SpO2 ≥90% (for ≥93% strong recommendation, for 90-92% weak recommendation)
  • A target SpO2 range of 90-94% seems reasonable for most patients and 88-92% for patients at risk of hypercapnic respiratory failure; use the minimum amount of oxygen necessary

—Michael Potts

 

References:

  1. Siemieniuk RAC, Chu DK, Kim LH, et al. Oxygen therapy for acutely ill medical patients: a clinical practice guideline [published online October 24, 2018]. BMJ. doi: https://doi.org/10.1136/bmj.k4169
  2. Chu DK, Kim LH, Young PJ, et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet. 2018;391:1693-705.