Dangers of hyperoxia

Mervyn Singer; Paul J. Young; John G. Laffey; Pierre Asfar; Fabio Silvio Taccone; Markus B. Skrifvars; Christian S. Meyhoff; Peter Radermacher

doi:10.1186/s13054-021-03815-y

Dangers of hyperoxia

Mervyn Singer, Paul J. Young, John G. Laffey, Pierre Asfar, Fabio Silvio Taccone, Markus B. Skrifvars, Christian S. Meyhoff, Peter Radermacher

Research output: Contribution to a Journal (Peer & Non Peer) › Review article › peer-review

179 Citations (Scopus)

Abstract

Oxygen (O₂) toxicity remains a concern, particularly to the lung. This is mainly related to excessive production of reactive oxygen species (ROS). Supplemental O₂, i.e. inspiratory O₂ concentrations (F_IO₂) > 0.21 may cause hyperoxaemia (i.e. arterial (a) PO₂ > 100 mmHg) and, subsequently, hyperoxia (increased tissue O₂ concentration), thereby enhancing ROS formation. Here, we review the pathophysiology of O₂ toxicity and the potential harms of supplemental O₂ in various ICU conditions. The current evidence base suggests that PaO₂ > 300 mmHg (40 kPa) should be avoided, but it remains uncertain whether there is an “optimal level” which may vary for given clinical conditions. Since even moderately supra-physiological PaO₂ may be associated with deleterious side effects, it seems advisable at present to titrate O₂ to maintain PaO₂ within the normal range, avoiding both hypoxaemia and excess hyperoxaemia.

Original language	English
Article number	440
Journal	Critical Care
Volume	25
Issue number	1
DOIs	https://doi.org/10.1186/s13054-021-03815-y
Publication status	Published - Dec 2021
Externally published	Yes

Keywords

Acute ischaemic stroke
ARDS
Cardiopulmonary resuscitation
Hyperoxaemia
Hyperoxia
Intracranial bleeding
Myocardial infarction
Reactive nitrogen species
Reactive oxygen species
Sepsis
Subarachnoidal bleeding
Surgical site infection
Trauma-and-haemorrhage
Traumatic brain injury

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s13054-021-03815-y

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title = "Dangers of hyperoxia",

abstract = "Oxygen (O2) toxicity remains a concern, particularly to the lung. This is mainly related to excessive production of reactive oxygen species (ROS). Supplemental O2, i.e. inspiratory O2 concentrations (FIO2) > 0.21 may cause hyperoxaemia (i.e. arterial (a) PO2 > 100 mmHg) and, subsequently, hyperoxia (increased tissue O2 concentration), thereby enhancing ROS formation. Here, we review the pathophysiology of O2 toxicity and the potential harms of supplemental O2 in various ICU conditions. The current evidence base suggests that PaO2 > 300 mmHg (40 kPa) should be avoided, but it remains uncertain whether there is an “optimal level” which may vary for given clinical conditions. Since even moderately supra-physiological PaO2 may be associated with deleterious side effects, it seems advisable at present to titrate O2 to maintain PaO2 within the normal range, avoiding both hypoxaemia and excess hyperoxaemia.",

keywords = "Acute ischaemic stroke, ARDS, Cardiopulmonary resuscitation, Hyperoxaemia, Hyperoxia, Intracranial bleeding, Myocardial infarction, Reactive nitrogen species, Reactive oxygen species, Sepsis, Subarachnoidal bleeding, Surgical site infection, Trauma-and-haemorrhage, Traumatic brain injury",

author = "Mervyn Singer and Young, \{Paul J.\} and Laffey, \{John G.\} and Pierre Asfar and Taccone, \{Fabio Silvio\} and Skrifvars, \{Markus B.\} and Meyhoff, \{Christian S.\} and Peter Radermacher",

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doi = "10.1186/s13054-021-03815-y",

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T1 - Dangers of hyperoxia

AU - Singer, Mervyn

AU - Young, Paul J.

AU - Laffey, John G.

AU - Asfar, Pierre

AU - Taccone, Fabio Silvio

AU - Skrifvars, Markus B.

AU - Meyhoff, Christian S.

AU - Radermacher, Peter

PY - 2021/12

Y1 - 2021/12

N2 - Oxygen (O2) toxicity remains a concern, particularly to the lung. This is mainly related to excessive production of reactive oxygen species (ROS). Supplemental O2, i.e. inspiratory O2 concentrations (FIO2) > 0.21 may cause hyperoxaemia (i.e. arterial (a) PO2 > 100 mmHg) and, subsequently, hyperoxia (increased tissue O2 concentration), thereby enhancing ROS formation. Here, we review the pathophysiology of O2 toxicity and the potential harms of supplemental O2 in various ICU conditions. The current evidence base suggests that PaO2 > 300 mmHg (40 kPa) should be avoided, but it remains uncertain whether there is an “optimal level” which may vary for given clinical conditions. Since even moderately supra-physiological PaO2 may be associated with deleterious side effects, it seems advisable at present to titrate O2 to maintain PaO2 within the normal range, avoiding both hypoxaemia and excess hyperoxaemia.

AB - Oxygen (O2) toxicity remains a concern, particularly to the lung. This is mainly related to excessive production of reactive oxygen species (ROS). Supplemental O2, i.e. inspiratory O2 concentrations (FIO2) > 0.21 may cause hyperoxaemia (i.e. arterial (a) PO2 > 100 mmHg) and, subsequently, hyperoxia (increased tissue O2 concentration), thereby enhancing ROS formation. Here, we review the pathophysiology of O2 toxicity and the potential harms of supplemental O2 in various ICU conditions. The current evidence base suggests that PaO2 > 300 mmHg (40 kPa) should be avoided, but it remains uncertain whether there is an “optimal level” which may vary for given clinical conditions. Since even moderately supra-physiological PaO2 may be associated with deleterious side effects, it seems advisable at present to titrate O2 to maintain PaO2 within the normal range, avoiding both hypoxaemia and excess hyperoxaemia.

KW - Acute ischaemic stroke

KW - ARDS

KW - Cardiopulmonary resuscitation

KW - Hyperoxaemia

KW - Hyperoxia

KW - Intracranial bleeding

KW - Myocardial infarction

KW - Reactive nitrogen species

KW - Reactive oxygen species

KW - Sepsis

KW - Subarachnoidal bleeding

KW - Surgical site infection

KW - Trauma-and-haemorrhage

KW - Traumatic brain injury

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U2 - 10.1186/s13054-021-03815-y

DO - 10.1186/s13054-021-03815-y

M3 - Review article

AN - SCOPUS:85121562970

SN - 1364-8535

VL - 25

JO - Critical Care

JF - Critical Care

IS - 1

M1 - 440

ER -

Dangers of hyperoxia

Abstract

Keywords

UN SDGs

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