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Scharffenberg M, Weiss T, Wittenstein J, Krenn K, Fleming M, Biro P, De Hert S, Hendrickx JFA, Ionescu D, de Abreu MG, Anaesthesiology ESo, Intensive Care: Practice of oxygen use in anesthesiology – a survey of the European Society of Anaesthesiology and Intensive Care. BMC Anesthesiol 2022; 22: 350

June 21, 2022

Background:
Oxygen is one of the most commonly used drugs by anesthesiologists. The World Health Organiza- tion (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 Inten- sive 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 (FiO2) ≥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, SpO2 ≤ 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 pulmo- nary diseases. Conclusions:
The current practice of perioperative oxygen therapy among respondents does not follow WHO rec- ommendations 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