Oxygen is liberally administered to many critically ill patients, thereby exposing them to supranormal arterial oxygen levels.
Hyperoxia results in the formation of reactive oxygen species, which adversely affect the pulmonary, vascular, cnetral nervous, and immune systems.
Though the optimal PaO2 remains unknown, recent evidence indicates that hyperoxia is associated with increased mortality in post-cardiac arrest, CVA, acute coronary syndrome, and traumatic brain injury patients.
Take Home Point: Carefully titrate oxygen to the lowest tolerable level to meet the patient's needs.
References
Helmerhorst HJF, et al. Association between arterial hyperoxia and outcomes in subsets of critical illness: A systematic review, meta-analysis, and meta-regression of cohort studies. Crit Care Med 2015; 43:1508-19.
