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Supporting oxygenation in acute respiratory failure.

Publication ,  Journal Article
MacIntyre, NR
Published in: Respir Care
January 2013

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.

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Published In

Respir Care

DOI

ISSN

0020-1324

Publication Date

January 2013

Volume

58

Issue

1

Start / End Page

142 / 150

Location

United States

Related Subject Headings

  • Ventilator-Induced Lung Injury
  • Respiratory System
  • Respiratory Insufficiency
  • Oxygen Inhalation Therapy
  • Oxygen Consumption
  • Oxygen
  • Hypoxia
  • Humans
  • Animals
  • Acute Disease
 

Citation

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MacIntyre, N. R. (2013). Supporting oxygenation in acute respiratory failure. Respir Care, 58(1), 142–150. https://doi.org/10.4187/respcare.02087
MacIntyre, Neil R. “Supporting oxygenation in acute respiratory failure.Respir Care 58, no. 1 (January 2013): 142–50. https://doi.org/10.4187/respcare.02087.
MacIntyre NR. Supporting oxygenation in acute respiratory failure. Respir Care. 2013 Jan;58(1):142–50.
MacIntyre, Neil R. “Supporting oxygenation in acute respiratory failure.Respir Care, vol. 58, no. 1, Jan. 2013, pp. 142–50. Pubmed, doi:10.4187/respcare.02087.
MacIntyre NR. Supporting oxygenation in acute respiratory failure. Respir Care. 2013 Jan;58(1):142–150.

Published In

Respir Care

DOI

ISSN

0020-1324

Publication Date

January 2013

Volume

58

Issue

1

Start / End Page

142 / 150

Location

United States

Related Subject Headings

  • Ventilator-Induced Lung Injury
  • Respiratory System
  • Respiratory Insufficiency
  • Oxygen Inhalation Therapy
  • Oxygen Consumption
  • Oxygen
  • Hypoxia
  • Humans
  • Animals
  • Acute Disease