Hyperoxia in acute care
Hyperoxia in acute care
This thesis of Renate Stevens-Stolmeijer examines the effects of hyperoxia: an excessively high level of oxygen in the blood. Oxygen is frequently administered in the emergency department (ED) and in prehospital care (for example ambulances).
Oxygen is necessary for energy production in our cells. Therefore, oxygen therapy is often used in critically ill patients. However, excessive oxygen can lead to the formation of so called “reactive oxygen species” that damage cells. Furthermore, hyperoxia can cause constriction of blood vessels, potentially reducing blood flow to organs.
Research presented in this thesis shows that hyperoxia is commonly present in patients who receive supplemental oxygen in the ED or the prehospital setting. Furthermore, the findings demonstrate that even a short exposure duration of high oxygen concentrations may impact the circulation in a negative way, resulting in constriction of blood vessels and a reduction in the volume of blood that is pumped around by the heart every minute. Fortunately, these effects seem reversible, and no evidence could be found for more structural oxidative damage after short-term exposure.
The thesis also demonstrates how oxygen therapy can be tailored. With a step-down protocol and monitoring of oxygen concentrations, normal oxygen saturation levels can often be achieved. However, hyperoxia may still go unnoticed in some cases. In situations with limited monitoring, prevention of hypoxia (oxygen shortage) is more important than prevention of hyperoxia, as the latter is generally more harmful.