Moritoki Egi1, Jun Kataoka2, Takashi Ito3, Osamu Nishida4, Hideto Yasuda5, Hiroshi Okamaoto6, Akira Shimoyama7, Masayo Izawa8, Shinsaku Matsumoto9, Nana Furushima10, Shigeki Yamashita11, Koji Takada12, Masahide Ohtsuka13, Noritomo Fujisaki14, Nobuaki Shime15, Nobuhiro Inagaki16, Yasuhiko Taira17, Tomoaki Yatabe18, Kenichi Nitta19, Takeshi Yokoyama20, Shigeki Kushimoto21, Kentaro Tokunaga22, Matsuyuki Doi23, Takahiro Masuda24, Yasuo Miki25, Kenichi Matsuda26, Takehiko Asaga27, Keita Hazama28, Hiroki Matsuyama29, Masaji Nishimura8, Satoshi Mizobuchi10. 1. Department of Anesthesiology, Kobe University Hospital, Hyogo, Japan. Electronic address: moriori@tg8.so-net.ne.jp. 2. Department of Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan. 3. Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. 4. Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Aichi, Japan. 5. Department of Intensive Care Medicine, Kameda Medical Center, Chiba, Japan. 6. Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan. 7. Department of Emergency Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan. 8. Emergency and Critical Care Medicine, Tokushima University Hospital, Tokushima, Japan. 9. Department of Anesthesia and Intensive Care, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan. 10. Department of Anesthesiology, Kobe University Hospital, Hyogo, Japan. 11. Department of Anesthesiology, Kurashiki Central Hospital, Okayama, Japan. 12. Department of Anesthesiology, Toyonaka Municipal Hospital, Osaka, Japan. 13. Department of Intensive Care Medicine, Yokohama City University Medical Center, Kanagawa, Japan. 14. Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Hyogo, Japan. 15. Department of Emergency and CriticalCare Medicine, Institute of Biomedical & Health Sciences, HiroshimaUniversity, Hiroshima, Japan. 16. Department of Emergency and Critical Care Medicine, Oita City Medical Association's Almeida Memorial Hospital, Oita, Japan. 17. Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kanagawa, Japan. 18. Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kochi, Japan. 19. Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, Nagano, Japan. 20. Intensive Care Unit, Department of Anesthesiology, Teine Keijinkai Hospital, Hokkaido, Japan. 21. Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan. 22. Department of Intensive Care Medicine, Kumamoto University Hospital, Kumamoto, Japan. 23. Intensive Care Unit, Hamamatsu University Hospital, Shizuoka, Japan. 24. Department of Critical Care Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. 25. Advanced Critical Care Center, Aichi Medical University Hospital, Aichi, Japan. 26. Department of Emergency and Critical Care Medicine, University of Yamanashi School of Medicine, Yamanashi, Japan. 27. Intensive Care Unit, Kagawa University Hospital, Kagawa, Japan. 28. Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School, Okayama, Japan. 29. Department of Anesthesia, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
Abstract
PURPOSE: To observe arterial oxygen in relation to fraction of inspired oxygen (FIO2) during mechanical ventilation (MV). MATERIALS AND METHODS: In this multicenter prospective observational study, we included adult patients required MV for >48h during the period from March to May 2015. We obtained FIO2, PaO2 and SaO2 from commencement of MV until the 7th day of MV in the ICU. RESULTS: We included 454 patients from 28 ICUs in this study. The median APACHE II score was 22. Median values of FIO2, PaO2 and SaO2 were 0.40, 96mmHg and 98%. After day two, patients spent most of their time with a FIO2 between 0.3 and 0.49 with median PaO2 of approximately 90mmHg and SaO2 of 97%. PaO2 was ≥100mmHg during 47.2% of the study period and was ≥130mmHg during 18.4% of the study period. FIO2 was more likely decreased when PaO2 was ≥130mmHg or SaO2 was ≥99% with a FIO2 of 0.5 or greater. When FIO2 was <0.5, however, FIO2 was less likely decreased regardless of the value of PaO2 and SaO2. CONCLUSIONS: In our multicenter prospective study, we found that hyperoxemia was common and that hyperoxemia was not corrected.
PURPOSE: To observe arterial oxygen in relation to fraction of inspired oxygen (FIO2) during mechanical ventilation (MV). MATERIALS AND METHODS: In this multicenter prospective observational study, we included adult patients required MV for >48h during the period from March to May 2015. We obtained FIO2, PaO2 and SaO2 from commencement of MV until the 7th day of MV in the ICU. RESULTS: We included 454 patients from 28 ICUs in this study. The median APACHE II score was 22. Median values of FIO2, PaO2 and SaO2 were 0.40, 96mmHg and 98%. After day two, patients spent most of their time with a FIO2 between 0.3 and 0.49 with median PaO2 of approximately 90mmHg and SaO2 of 97%. PaO2 was ≥100mmHg during 47.2% of the study period and was ≥130mmHg during 18.4% of the study period. FIO2 was more likely decreased when PaO2 was ≥130mmHg or SaO2 was ≥99% with a FIO2 of 0.5 or greater. When FIO2 was <0.5, however, FIO2 was less likely decreased regardless of the value of PaO2 and SaO2. CONCLUSIONS: In our multicenter prospective study, we found that hyperoxemia was common and that hyperoxemia was not corrected.