Supporting oxygenation in acute respiratory failure.

Journal Article (Journal Article;Review)

Strategies to support oxygenation can cause substantial harm through lung stretch injury, oxygen toxicity, transfusion risks and cardiac over-stimulation. Traditional goals of maintaining near normal cardiorespiratory parameters are most likely overly simplistic and are insensitive and nonspecific for tissue hypoxic effects. In order to reduce iatrogenic harm, it is conceivable that clinicians could be comfortable with lower levels of arterial oxygen content (eg, oxyhemoglobin values of < 88%: so called "permissive hypoxemia"), provided that there are ways to effectively monitor tissue hypoxia. We can learn more about hypoxic compensatory mechanisms from the fetus and from high altitude residents. We also need to learn better ways of monitoring tissue oxygenation, especially in "mission critical" tissues. Ultimately clinical trials will be needed to determine appropriate oxygenation targets to allow permissive hypoxemia.

Full Text

Duke Authors

Cited Authors

  • MacIntyre, NR

Published Date

  • January 2013

Published In

Volume / Issue

  • 58 / 1

Start / End Page

  • 142 - 150

PubMed ID

  • 23271824

International Standard Serial Number (ISSN)

  • 0020-1324

Digital Object Identifier (DOI)

  • 10.4187/respcare.02087


  • eng

Conference Location

  • United States