Oxygen causing harm?

[wrmedic82]

I was hoping to see if anyone could find me literature or studies supporting the claim of oxygen given to a patient with a spo2 >95% causes harm at the cellular level. Out medical control officers swear by this, however google is not being my friend to research the literature on this subject. Granted, as with any drug. There should always be a rhyme and reason for administering anything. So understand I don't routinely give oxygen unless someone convinces me they need it. (The 4 hypoxias).

[cprted]

http://www.jems.com/behind-the-mask

[chbare]

There is actually a fair amount of literature about this issue. I am not sure how much physical science you have but Oxygen at "normal" levels is harmful. Mammals have evolved complex enzyme systems to deal with the consequences of Oxygen and highly reactive molecules and forms of Oxygen known as reactive Oxygen species or ROS. These are a natural consequence of normal cellular respiration. Heck, our immune system sometimes makes use of ROS as part of the inflammatory response and when attacking pathogens. While mammalian physiology is generally good at dealing with ROS, many situations can markedly increase the amount of ROS being produced. This is known as oxidative stress. Good luck looking for literature. It's certainly out there but a perfectly clear and concise picture has not been completely developed.

[ERDoc]

Have you checked pubmed?

[mikeymedic1984]

I have been doing this for a long time and I have never seen a COPD pt's hypoxic drive knocked out by O2, probably because I have always administered the right amount. With that being said, would you rather have a critical pt with a sat of 72% or 92%, regardless of how they got critical ?

I just picked up an elderly pt who was satting around 80% on room last week, but was talking and did not look like an 80 percenter; with 4L of O2 and repositioning, she was in the 90s in no time. As with any treatment, it needs to be titrated to the patient at-hand, not dosed out as the cookbook dictates. Not everyone with a low sat needs high-flow O2, but those who need high-flow O2 should not have it withheld because of an irrational fear of the CO2 boogeyman.

[triemal04]

You do realize that the reasoning behind the current trend of titrating the delivery of oxygen has nothing to do with the hypoxic drive, right?

[ghostmed3]

Ece or aha 2010. I believe its cardiac section though

Ecc 2010 sry

The thought behind keeping o2 levels 95% range is mainly in cva or severe mi cases from what I understand. An increase of high saturation is reported to actually constrict artery blood flow and thus actually casuse more damage to these pts.

[BushyFromOz]

http://www.bmj.com/content/341/bmj.c5462

Thats the one i could think of off the top of my head

Personanally, im looking forward to the AVOID (Air Versus Oxygen In myocarDial infarction) trial to release its resulst

But theres a bit out there

Edited November 18, 2014 by BushyFromOz

[triemal04]

Personanally, im looking forward to the AVOID (Air Versus Oxygen In myocarDial infarction) trial to release its resulst

But theres a bit out there

They've been enrolling patients for a couple of years in your neck of the woods; any news on when they have all the patients they need?

I'm sure it'll be taken into account, but be curious to see how far they break down and differentiate the different MI's; just based on location and time, or will it be based on TIMI flow? Or something else?

[Caduceus]

There is this article online having to do with hypoxic drive and COPD pts.

http://paramedicblog.wordpress.com/2009/11/19/hypoxic-drive-theory-myth-the-why-and-how/