Abstract
Supratherapeutic oxygen levels consistently cause oxygen toxicity in the lungs and
other organs. The prevalence and severity of hyperoxemia among pediatric intensive
care unit (PICU) patients remain unknown. This was the first study to examine the
prevalence and duration of hyperoxemia in PICU patients receiving oxygen therapy.
This is a retrospective chart review. This was performed in a setting of 36-bed PICU
in a quaternary-care children's hospital. All the patients were children aged <18
years, admitted to the PICU for ≥24 hours, receiving oxygen therapy for ≥12 hours
who had at least one arterial blood gas during this time.
There was no intervention. Of 5,251 patients admitted to the PICU, 614 were included
in the study. On average, these patients received oxygen therapy for 91% of their
time in the PICU and remained hyperoxemic, as measured by pulse oximetry, for 65%
of their time on oxygen therapy. Patients on oxygen therapy remained hyperoxemic for
a median of 38 hours per patient and only 1.1% of patients did not experience any
hyperoxemia. Most of the time (87.5%) patients received oxygen therapy through a fraction
of inspired oxygen (FiO2)-adjustable device. Mean FiO2 on noninvasive support was 0.56 and on invasive support was 0.37. Mean partial pressure
of oxygen (PaO2) on oxygen therapy was 108.7 torr and 3,037 (42.1%) of PaO2 measurements were >100 torr. Despite relatively low FiO2, PICU patients receiving oxygen therapy are commonly exposed to prolonged hyperoxemia,
which may contribute to ongoing organ injury.
Keywords
hyperoxemia - oxygen therapy - oxygen toxicity - mechanical ventilation
