Bedside tip: How to select SpO2 targets

30.08.2017
Author: Clinical Experts Group, Hamilton Medical, Reviewer: Paul Garbarini, David Grooms, Simon Franz

In mechanically ventilated patients, SpO2 targets are selected according to the previous lung condition and the actual severity of the disease.

For patients with a normal lung before ICU admission, the SpO2 targets are 94%-98% (1) or 92%-96% (2). The safe lower limit for SpO2 is considered to be 90%.

For patients with previous chronic respiratory failure at risk of oxygen-induced hypercapnia, SpO2 targets are 88%-92%. The safe lower SpO2 limit is 85%.

SpO2 targets for ARDS patients are 88%-95% (3, 4).

SpO2 targets for brain injury and post-cardiac arrest patients are 94%-98% (1, 6).

Patients with carbon monoxide poisoning should receive normobaric hyperoxia or hyperbaric oxygen. Pulse oximetry is likely to be inaccurate in this case.

Patients previously exposed to Bleomycin or poisoned with paraquat should have SpO2 targets of 88%-92%.

When using INTELLiVENT-ASV*, default SpO2 target ranges vary according to the clinical condition selected by the user: 93%-97% for normal lung and ARDS patients, 88%-93% for chronic hypercapnia patients, and 96%-99% for brain injury. However, these default targets are automatically lower for high PEEP and target ranges can be adjusted by the user at any time.

* Not available in the US and some other markets

References

  1. O'Driscoll BR, Howard LS, Davison AG; British Thoracic Society. BTS guideline for emergency oxygen use in adult patients. Thorax 2008;63:vi1-68. 
  2. Beasley R, Chien J, Douglas J, Eastlake L, Farah C, King G, et al. Thoracic Society of Australia and New Zealand oxygen guidelines for acute oxygen use in adults: 'Swimming between the flags'. Respirology 2015;20:1182-91. 
  3. Bein T, Grasso S, Moerer O, Quintel M, Guerin C, Deja M, et al. The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia. Intensive Care Med 2016;42:699-711. 
  4. NIH NHLBI ARDS Clinical Network Mechanical Ventilation Protocol Summary 2008-07.
  5. Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary. Eur Respir J 2017;49. 
  6. Nolan JP, Soar J, Cariou A, Cronberg T, Moulaert VR, Deakin CD, et al. European Resuscitation Council and European Society of Intensive Care Medicine 2015 guidelines for post-resuscitation care. Intensive Care Med 2015;41:2039-56. (Abstract only)

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spo2, spo2 targets, ARDS, normal lung, hypercapnia, brain injury, PEEP
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Date of Printing: 10.12.2018
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