Martin, D;
Grocott, M;
(2017)
Oxygen therapy and the Goldilocks principle.
[Editorial comment].
J Intensive Care Soc
, 18
(4)
pp. 279-281.
10.1177/1751143717712162.
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Abstract
Whilst fundamental to human survival, oxygen is harmful in excess and it is possible that as intensive care specialists, we focus less attention on its use than might be expected by the public and patients who we treat.1 In a clinical environment where it is rare to not administer oxygen to a patient, one would have presumed that we would be awash with evidence and guidance about its use. Surely decades of clear and indisputable findings must underpin how we use the most commonly administered drug in intensive care units the world over. Not so, it would seem. Huge variation in practice can be demonstrated2,3 and whilst harder to quantify, there is undoubtedly a wide spectrum of beliefs underpinning this inconsistency. It is our belief that each and every patient requires careful assessment and individualised oxygen titration to achieved desired targets, rather than having a universal ‘one-size-fits-all’ prescription imposed upon them. What is lacking though is the evidence on which to base clinical guidance. Therefore, we find ourselves in an awkward position; both too little and too much oxygen is harmful. Yet currently we are uncertain what the right amount of oxygen is for individual critically ill patients.
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