Management of Adult Patients With Oxygen in the Acute Care Setting
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Overview
Title
Management of Adult Patients With Oxygen in the Acute Care Setting
Authoring Organization
American Association for Respiratory Care
Publication Month/Year
November 2, 2021
Document Type
Guideline
Country of Publication
US
Document Objectives
Providing supplemental oxygen to hospitalized adults is a frequent practice and can be administered via a variety of devices. Oxygen therapy has evolved over the years, and clinicians should follow evidence-based practices to provide maximum benefit and avoid harm. This systematic review and subsequent clinical practice guidelines were developed to answer questions about oxygenation targets, monitoring, early initiation of high-flow oxygen (HFO), benefits of HFO compared to conventional oxygen therapy, and humidification of supplemental oxygen. Using a modification of the RAND/UCLA Appropriateness Method, 7 recommendations were developed to guide the delivery of supplemental oxygen to hospitalized adults: (1) aim for SpO2 range of 94-98% for most hospitalized patients (88-92% for those with COPD), (2) the same SpO2 range of 94-98% for critically ill patients, (3) promote early initiation of HFO, (4) consider HFO to avoid escalation to noninvasive ventilation, (5) consider HFO immediately postextubation to avoid re-intubation, (6) either HFO or conventional oxygen therapy may be used with patients who are immunocompromised, and (7) consider humidification for supplemental oxygen when flows > 4 L/min are used.
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Emergency care, Hospital, Operating and recovery room
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Management
Diseases/Conditions (MeSH)
D010100 - Oxygen
Keywords
oxygen, acute care, airway