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Critical care


Oxygen paradox Inside the


In recent years, a number of studies have found that conservative, normoxic oxygenation strategies could yield certain benefi ts and can help reduce mortality. Recently, a study conducted by researchers at UCL and Great Ormond Street Hospital has found similar fi ndings with reduced oxygen levels in critically ill children on mechanical ventilators potentially saving tens of young lives each year. Roughly 20,000 children are admitted to intensive care each year; with three-quarters requiring oxygen through a ventilator, how can reduced oxygen result in improved health outcomes? Monica Karpinski speaks to associate professor of medicine and critical care physician at Vanderbilt University Medical Centre, Matthew Semler and Mark Peters professor of paediatric intensive care at University College London Great Ormond Street Institute of Child Health to investigate the latest research to fi nd out whether reduced oxygen could help save lives.


ince its first reported use in acute care in 1885, oxygen has become a mainstay of clinical practice. It’s the most used drug in emergency medicine today, where it’s typically prescribed to prevent hypoxemia by bringing the amount of oxygen in the blood to around 94–98%, towards normal levels.


S Practical Patient Care / www.practical-patient-care.com


This widespread use of oxygen has largely gone unquestioned: after all, it’s considered very safe and low levels can be dangerous. Yet, until very recently, there’s been a lack of experimental evidence supporting the use of oxygen therapy. “We’ve never had any rigorous trials evaluating its impact on patient outcomes until the last five


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