Thoracic Society of Australia and New Zealand Position Statement on Acute Oxygen Use in Adults: 'Swimming between the flags'

Adrian Barnett; Richard Beasley; Catherine Buchan; Jimmy Chien; Claude S Farah; Gregory King; Christine F McDonald; Belinda Miller; Maitri Munsif; Alex Psirides; Lynette Reid; Mary Roberts; Natasha Smallwood; Sheree Smith

doi:10.1111/resp.14218

Thoracic Society of Australia and New Zealand Position Statement on Acute Oxygen Use in Adults: 'Swimming between the flags'

Respirology. 2022 Apr;27(4):262-276. doi: 10.1111/resp.14218. Epub 2022 Feb 17.

Authors

Adrian Barnett¹, Richard Beasley², Catherine Buchan^{3

4}, Jimmy Chien⁵, Claude S Farah⁶, Gregory King⁷, Christine F McDonald⁸, Belinda Miller⁹, Maitri Munsif⁸, Alex Psirides¹⁰, Lynette Reid¹¹, Mary Roberts⁵, Natasha Smallwood^{3

4}, Sheree Smith¹²

Affiliations

¹ Department of Respiratory and Sleep Medicine, Mater Public Hospital, South Brisbane, Queensland, Australia.
² Medical Research Institute of New Zealand & Capital Coast District Health Board, Wellington, New Zealand.
³ Department of Respiratory and Sleep Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
⁴ Department of Immunology and Respiratory Medicine, Monash University, Melbourne, Victoria, Australia.
⁵ Department of Respiratory and Sleep Medicine, Westmead Hospital, Ludwig Engel Centre for Respiratory Research and University of Sydney, Sydney, New South Wales, Australia.
⁶ Department of Respiratory Medicine, Concord Hospital, Macquarie University and University of Sydney, Sydney, New South Wales, Australia.
⁷ Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Woolcock Institute of Medical Research and University of Sydney, Sydney, New South Wales, Australia.
⁸ Department of Respiratory and Sleep Medicine, Austin Health and University of Melbourne, Melbourne, Victoria, Australia.
⁹ Department of Respiratory Medicine, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia.
¹⁰ Intensive Care Unit, Wellington Regional Hospital, Capital and Coast District Health Board, Wellington, New Zealand.
¹¹ Respiratory Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
¹² School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia.

Abstract

Oxygen is a life-saving therapy but, when given inappropriately, may also be hazardous. Therefore, in the acute medical setting, oxygen should only be given as treatment for hypoxaemia and requires appropriate prescription, monitoring and review. This update to the Thoracic Society of Australia and New Zealand (TSANZ) guidance on acute oxygen therapy is a brief and practical resource for all healthcare workers involved with administering oxygen therapy to adults in the acute medical setting. It does not apply to intubated or paediatric patients. Recommendations are made in the following six clinical areas: assessment of hypoxaemia (including use of arterial blood gases); prescription of oxygen; peripheral oxygen saturation targets; delivery, including non-invasive ventilation and humidified high-flow nasal cannulae; the significance of high oxygen requirements; and acute hypercapnic respiratory failure. There are three sections which provide (1) a brief summary, (2) recommendations in detail with practice points and (3) a detailed explanation of the reasoning and evidence behind the recommendations. It is anticipated that these recommendations will be disseminated widely in structured programmes across Australia and New Zealand.

Keywords: acute oxygen therapy; oxygen prescription; position statement; target oxygen saturations; titrated oxygen.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Child
Humans
Hypoxia / therapy
New Zealand
Oxygen
Oxygen Inhalation Therapy*

Substances

Oxygen