Practice of oxygen administration in patients hospitalized in internal medicine wards and intensive care units: A single-center prospective, observational study

TL;DR

This study examines how often oxygen is improperly administered to hospitalized patients in internal medicine and ICU settings.

Contribution

The study identifies high rates of inappropriate oxygen administration in a single hospital's internal medicine and ICU units.

Findings

20% of internal medicine patients and 50% of ICU patients received oxygen.

46% of simple face mask applications used inappropriate flow rates.

62% of COPD exacerbation patients had SpO2 levels above 92%.

Abstract

Oxygen is widely used to treat hypoxemia.

To determine the frequency of inappropriate oxygen administration in patients admitted to Internal Medicine (IM) wards and intensive care units (ICU).

Single-center prospective, observational study in a tertiary university hospital in Ankara, Türkiye.

Patients who were hospitalized in the IM wards and ICU and were receiving oxygen were recruited. Every 6 hours, the oxygenation parameters were noted, and the averages over the first 24 hours of oxygen usage were recorded. Inappropriate usage was defined as oxygen flow rates > 6 L/min in the nasal cannula and < 5 L/min and > 10 L/min in the simple face mask, application of the simple face mask in chronic obstructive lung disease (COPD) exacerbation, SpO2 > 98% in general, or SpO2 > 92% in COPD exacerbation.

Of the 397 patients, 20% in the IM wards and 50% of 124 in the ICU received oxygen. The oxygen method used was nasal cannula in 51%, simple face mask in 21%, and high-flow nasal cannula in 4% of the patients. Among the simple face mask applications, 46% were < 5 L/min and 5% were > 10 L/min. Among the 62% of patients with COPD exacerbations, the SpO2 was > 92%.

The frequency of oxygen use was 20% among patients hospitalized in IM wards and 50% among patients in the ICU. Almost half of the simple face mask applications were inappropriate.

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