Oxygen therapy assessment in adult patients at an intensive care unit of a teaching hospital
DOI:
https://doi.org/10.30968/rbfhss.2023.143.0915Abstract
Objective: to carry out a situational diagnosis of the adequacy of oxygen therapy prescriptions in an adult intensive care unit (ICU) of a teaching hospital in Northeast Brazil. Methods: this is a cross-sectional, descriptive, retrospective, and quantitative study, in which the medical records and prescriptions of patients using oxygen, admitted to the ICU between March and June 2021, were evaluated, based on the guidelines of the British Thoracic Society (BTS). This advocates that target O₂ saturation, delivery device and initial O₂ flow are minimum and mandatory criteria for prescribing oxygen therapy. The project is part of a larger research approved by the ethics committee in research involving human beings with the number 3,709,534 (CAAE n° 22984119.9.0000.5546). Results: The sample consisted of 42 patients. Of these, 90.5% had an indication for the use of oxygen, but only 71.4% had oxygen therapy in the prescription. No prescription contained the target saturation, 64.3% had the delivery device, and 16.7% contained the initial flow or inspired fraction of O₂. Conclusion: The study demonstrated that oxygen prescriptions in the researched care unit do not meet the BTS recommendations and that interventions should be performed to make care safer.
Downloads
References
Poitou P, Fouret C, Duffau E. [Regulations on gases for medical use in France. Annales pharmaceutiques francaises [Internet]. 2002 Sep 1;60(5):326–32.
Associação Portuguesa das Empresas Químicas - APEQ. Manual hospitalar: boas práticas de gestão de gases medicinais. Lisboa: APEQ; 2017. Available on: https://www.ordemfarmaceuticos.pt/fotos/publicacoes/manual_hospitalar_boas_praticas_de_gestao_de_gases_medicinais_14117516575b06b2ae12906.pdf. Accessed on: 22th Oct 2021.
Ministério da Saúde. Agência Nacional de Vigilância Sanitária – ANVISA. RDC nº 69 de 1 º de outubro de 2008. Dispõe sobre as Boas Práticas de Fabricação de Gases Medicinais. Brasil; 2008.
Ministério da Saúde. Agência Nacional de Vigilância Sanitária – ANVISA. RDC nº 70 de 1 º de outubro de 2008. Dispõe sobre a notificação de Gases Medicinais. Brasil; 2008.
González-Moro JMR, Bravo QL, Alcázar NB, et al. Oxigenoterapia continua domiciliaria. Open Respiratory Archives [Internet]. 2020 Apr 1;2(2):33–45. DOI: 10.1016/j.opresp.2020.03.004
Brueckl C, Kaestle S, Kerem A, et al. Hyperoxia-Induced Reactive Oxygen Species Formation in Pulmonary Capillary Endothelial Cells In Situ. American Journal of Respiratory Cell and Molecular Biology. 2006 Apr;34(4):453–63.DOI: 10.1165/rcmb.2005-0223OC
Vincent J-L, Taccone FS, He X. Harmful Effects of Hyperoxia in Postcardiac Arrest, Sepsis, Traumatic Brain Injury, or Stroke: The Importance of Individualized Oxygen Therapy in Critically Ill Patients. Canadian Respiratory Journal. 2017;2017:1.DOI: 10.1155/2017/2834956
Conselho Federal de Farmácia. Resolução nº 731, de 25 de agosto de 2022 - Dispõe sobre as atribuições e competências do farmacêutico nas atividades que envolvem gases medicinais. Imprensa Nacional [Internet]. www.in.gov.br. [cited 2023 Jan 12]. Available from: https://www.in.gov.br/en/web/dou/-/resolucao-n-731-de-25-de-agosto-de-2022-427633572.
O’Driscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax 2008 Oct 1;63(Supplement 6):vi1–68. DOI: org/10.1136/thx.2008.102947
O’Driscoll BR, Howard LS, Earis J, et al. BTS Guideline for Oxygen Use in Adults in Healthcare and Emergency Settings. Thorax. 2017 May 15;72(1):ii1–90. DOI: 10.1136/thoraxjnl-2016-209729
Ministério da Saúde. Agência Nacional de Vigilância Sanitária. Anexo 03: Protocolo de segurança na prescrição, uso e administração de medicamentos; 2013. Disponível em: https://www20.anvisa.gov.br/segurancadopaciente/index.php/publicacoes/item/seguranca-na-prescriccao-uso-e-administracao-de-medicamentos. Acesso em 5 mar 2022.
Stuart-Harris C, Bishop JM, Clark TJH, et al. Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema: Report of the Medical Research Council Working Party. 1981.i:681-6.
Dodd ME. Audit of oxygen prescribing before and after the introduction of a prescription chart. BMJ. 2000 Oct 7;321(7265):864–5.DOI: 10.1136/bmj.321.7265.864
Gunathilake R, Lowe D, Wills J, et al. Implementation of a multicomponent intervention to optimise patient safety through improved oxygen prescription in a rural hospital. Australian Journal of Rural Health. 2014 Dec;22(6):328–33.DOI: 10.1111/ajr.12115
Wijesinghe M, Shirtcliffe P, Perrin K, et al. An audit of the effect of oxygen prescription charts on clinical practice. Postgraduate Medical Journal. 2010 Feb 1;86(1012):89–93. DOI 10.1136/pgmj.2009.087528
Chu DK, Kim LH-Y, Young PJ, et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet. 2018;391(10131):1693–705. DOI: 10.1016/S0140-6736(18)30479-3
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Authors
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The authors hereby transfer, assign, or otherwise convey to RBFHSS: (1) the right to grant permission to republish or reprint the stated material, in whole or in part, without a fee; (2) the right to print republish copies for free distribution or sale; and (3) the right to republish the stated material in any format (electronic or printed). In addition, the undersigned affirms that the article described above has not previously been published, in whole or part, is not subject to copyright or other rights except by the author(s), and has not been submitted for publication elsewhere, except as communicated in writing to RHFHSS with this document.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-NC-ND) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Serlf-archiving policy
This journal permits and encourages authors to post and archive the final pdf of the articles submitted to the journal on personal websites or institutional repositories after publication, while providing bibliographic details that credit its publication in this journal.
