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Practice of oxygen use in anesthesiology : a survey of the European Society of Anaesthesiology and Intensive Care

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Abstract
Background Oxygen is one of the most commonly used drugs by anesthesiologists. The World Health Organization (WHO) gave recommendations regarding perioperative oxygen administration, but the practice of oxygen use in anesthesia, critical emergency, and intensive care medicine remains unclear. Methods We conducted an online survey among members of the European Society of Anaesthesiology and Intensive Care (ESAIC). The questionnaire consisted of 46 queries appraising the perioperative period, emergency medicine and in the intensive care, knowledge about current recommendations by the WHO, oxygen toxicity, and devices for supplemental oxygen therapy. Results Seven hundred ninety-eight ESAIC members (2.1% of all ESAIC members) completed the survey. Most respondents were board-certified and worked in hospitals with > 500 beds. The majority affirmed that they do not use specific protocols for oxygen administration. WHO recommendations are unknown to 42% of respondents, known but not followed by 14%, and known and followed by 24% of them. Respondents prefer inspiratory oxygen fraction (FiO(2)) >= 80% during induction and emergence from anesthesia, but intraoperatively < 60% for maintenance, and higher FiO(2) in patients with diseased than non-diseased lungs. Postoperative oxygen therapy is prescribed more commonly according to peripheral oxygen saturation (SpO(2)), but shortage of devices still limits monitoring. When monitoring is used, SpO(2) <= 95% is often targeted. In critical emergency medicine, oxygen is used frequently in patients aged >= 80 years, or presenting with respiratory distress, chronic obstructive pulmonary disease, myocardial infarction, and stroke. In the intensive care unit, oxygen is mostly targeted at 96%, especially in patients with pulmonary diseases. Conclusions The current practice of perioperative oxygen therapy among respondents does not follow WHO recommendations or current evidence, and access to postoperative monitoring devices impairs the individualization of oxygen therapy. Further research and additional teaching about use of oxygen are necessary.
Keywords
Oxygen therapy, Supplemental oxygen, Patient safety, Inspiratory, fraction of oxygen, Perioperative care, Intensive care medicine, Critical emergency medicine, Oxygen toxicity, WHO guidelines on surgical, site infection prevention, SURGICAL SITE INFECTION, POSTOPERATIVE PULMONARY COMPLICATIONS, SUPPLEMENTAL PERIOPERATIVE OXYGEN, HYPEROXIA INDUCES INFLAMMATION, ELECTIVE COLORECTAL SURGERY, DOUBLE-BLIND, INSPIRED OXYGEN, 30-35-PERCENT FRACTION, RECTAL-CANCER, 80-PERCENT

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MLA
Scharffenberg, Martin, et al. “Practice of Oxygen Use in Anesthesiology : A Survey of the European Society of Anaesthesiology and Intensive Care.” BMC ANESTHESIOLOGY, vol. 22, no. 1, BMC, 2022, doi:10.1186/s12871-022-01884-2.
APA
Scharffenberg, M., Weiss, T., Wittenstein, J., Krenn, K., Fleming, M., Biro, P., … de Abreu, M. G. (2022). Practice of oxygen use in anesthesiology : a survey of the European Society of Anaesthesiology and Intensive Care. BMC ANESTHESIOLOGY, 22(1). https://doi.org/10.1186/s12871-022-01884-2
Chicago author-date
Scharffenberg, Martin, Thomas Weiss, Jakob Wittenstein, Katharina Krenn, Magdalena Fleming, Peter Biro, Stefan De Hert, Jan Hendrickx, Daniela Ionescu, and Marcelo Gama de Abreu. 2022. “Practice of Oxygen Use in Anesthesiology : A Survey of the European Society of Anaesthesiology and Intensive Care.” BMC ANESTHESIOLOGY 22 (1). https://doi.org/10.1186/s12871-022-01884-2.
Chicago author-date (all authors)
Scharffenberg, Martin, Thomas Weiss, Jakob Wittenstein, Katharina Krenn, Magdalena Fleming, Peter Biro, Stefan De Hert, Jan Hendrickx, Daniela Ionescu, and Marcelo Gama de Abreu. 2022. “Practice of Oxygen Use in Anesthesiology : A Survey of the European Society of Anaesthesiology and Intensive Care.” BMC ANESTHESIOLOGY 22 (1). doi:10.1186/s12871-022-01884-2.
Vancouver
1.
Scharffenberg M, Weiss T, Wittenstein J, Krenn K, Fleming M, Biro P, et al. Practice of oxygen use in anesthesiology : a survey of the European Society of Anaesthesiology and Intensive Care. BMC ANESTHESIOLOGY. 2022;22(1).
IEEE
[1]
M. Scharffenberg et al., “Practice of oxygen use in anesthesiology : a survey of the European Society of Anaesthesiology and Intensive Care,” BMC ANESTHESIOLOGY, vol. 22, no. 1, 2022.
@article{01GM3CPXVFBQJ7465MD8Y2NHBH,
  abstract     = {{Background Oxygen is one of the most commonly used drugs by anesthesiologists. The World Health Organization (WHO) gave recommendations regarding perioperative oxygen administration, but the practice of oxygen use in anesthesia, critical emergency, and intensive care medicine remains unclear. Methods We conducted an online survey among members of the European Society of Anaesthesiology and Intensive Care (ESAIC). The questionnaire consisted of 46 queries appraising the perioperative period, emergency medicine and in the intensive care, knowledge about current recommendations by the WHO, oxygen toxicity, and devices for supplemental oxygen therapy. Results Seven hundred ninety-eight ESAIC members (2.1% of all ESAIC members) completed the survey. Most respondents were board-certified and worked in hospitals with > 500 beds. The majority affirmed that they do not use specific protocols for oxygen administration. WHO recommendations are unknown to 42% of respondents, known but not followed by 14%, and known and followed by 24% of them. Respondents prefer inspiratory oxygen fraction (FiO(2)) >= 80% during induction and emergence from anesthesia, but intraoperatively < 60% for maintenance, and higher FiO(2) in patients with diseased than non-diseased lungs. Postoperative oxygen therapy is prescribed more commonly according to peripheral oxygen saturation (SpO(2)), but shortage of devices still limits monitoring. When monitoring is used, SpO(2) <= 95% is often targeted. In critical emergency medicine, oxygen is used frequently in patients aged >= 80 years, or presenting with respiratory distress, chronic obstructive pulmonary disease, myocardial infarction, and stroke. In the intensive care unit, oxygen is mostly targeted at 96%, especially in patients with pulmonary diseases. Conclusions The current practice of perioperative oxygen therapy among respondents does not follow WHO recommendations or current evidence, and access to postoperative monitoring devices impairs the individualization of oxygen therapy. Further research and additional teaching about use of oxygen are necessary.}},
  articleno    = {{350}},
  author       = {{Scharffenberg, Martin and  Weiss, Thomas and  Wittenstein, Jakob and  Krenn, Katharina and  Fleming, Magdalena and  Biro, Peter and De Hert, Stefan and Hendrickx, Jan and  Ionescu, Daniela and  de Abreu, Marcelo Gama}},
  issn         = {{1471-2253}},
  journal      = {{BMC ANESTHESIOLOGY}},
  keywords     = {{Oxygen therapy,Supplemental oxygen,Patient safety,Inspiratory,fraction of oxygen,Perioperative care,Intensive care medicine,Critical emergency medicine,Oxygen toxicity,WHO guidelines on surgical,site infection prevention,SURGICAL SITE INFECTION,POSTOPERATIVE PULMONARY COMPLICATIONS,SUPPLEMENTAL PERIOPERATIVE OXYGEN,HYPEROXIA INDUCES INFLAMMATION,ELECTIVE COLORECTAL SURGERY,DOUBLE-BLIND,INSPIRED OXYGEN,30-35-PERCENT FRACTION,RECTAL-CANCER,80-PERCENT}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{11}},
  publisher    = {{BMC}},
  title        = {{Practice of oxygen use in anesthesiology : a survey of the European Society of Anaesthesiology and Intensive Care}},
  url          = {{http://doi.org/10.1186/s12871-022-01884-2}},
  volume       = {{22}},
  year         = {{2022}},
}

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