Clinicians' attitudes towards supplemental oxygen for trauma patients - A survey

被引：0

作者：

Arleth, Tobias ^{[1
]}

Baekgaard, Josefine ^{[1
]}

Rosenkrantz, Oscar ^{[1
]}

Zwisler, Stine T. ^{[2
,3
]}

Andersen, Mikkel ^{[4
,5
]}

Maissan, Iscander M. ^{[6
]}

Hautz, Wolf E. ^{[7
]}

Verdonck, Philip ^{[8
,9
]}

Rasmussen, Lars S. ^{[10
]}

Steinmetz, Jacob ^{[1
,5
,11
,12
]}

机构：

[1] Univ Copenhagen, Rigshosp, Ctr Head & Orthopaed, Dept Anaesthesia, Inge Lehmanns Vej 6, DK-2100 Copenhagen, Denmark

[2] Odense Univ Hosp, Dept Anaesthesiol & Intens Care, J B Winslows Vej 4, DK-5000 Odense C, Denmark

[3] Odense Univ Hosp, Prehosp Res Unit, Kildemosevej 15, DK-5000 Odense C, Denmark

[4] Aarhus Univ Hosp, Dept Anaesthesia, Palle Juul Jensens Blvd 165, DK-8200 Aarhus N, Denmark

[5] Danish Air Ambulance, Brendstrupgardsvej 7, DK-8200 Aarhus N, Denmark

[6] Erasmus MC, Dept Anaesthesiol, Dr Molewaterplein 40, NL-3015 GD Rotterdam, Netherlands

[7] Univ Hosp Bern, Dept Emergency Med, Freiburgstr 20, CH-3010 Bern, Switzerland

[8] Antwerp Univ Hosp, Dept Gastroenterol & Hepatol, Drie Eikenstr 655, Antwerp, Belgium

[9] Univ Antwerp, Fac Med & Hlth Sci, Univ Pl 1, B-2610 Antwerp, Belgium

[10] Danish Minist Def Personnel Agcy, HC Sneedorffs 3, DK-1439 Copenhagen, Denmark

[11] Univ Copenhagen, Inst Clin Med, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark

[12] Aarhus Univ, Fac Hlth, Vennelyst Blvd 4, DK-8000 Aarhus, Denmark

来源：

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2025年 / 56卷 / 01期

关键词：

Trauma; Injury; Supplemental oxygen; Survey; Attitudes; Clinicians; European; SELF-REPORTED PRACTICE; THERAPY; OPINION; PERCEPTIONS; MORTALITY; FRACTION;

D O I：

10.1016/j.injury.2024.111929

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Introduction: The Advanced Trauma Life Support guidelines (ATLS; 2018, 10th ed.) recommend an early and liberal supplemental oxygen for all severely injured trauma patients to prevent hypoxaemia. As of 2024, these guidelines remain the most current. This may lead to hyperoxaemia, which has been associated with increased mortality and respiratory complications. We aimed to investigate the attitudes among clinicians, defined as physicians and prehospital personnel, towards the use of supplemental oxygen in trauma cases. Materials and methods: A European, web-based, cross-sectional survey was conducted consisting of 23 questions. The primary outcome was the question: "In your opinion, should all severely injured trauma patients always be given supplemental oxygen, regardless of arterial oxygen saturation measured by pulse oximetry?". Results: The survey was answered by 707 respondents, which corresponded to a response rate of 52 %. The respondents were predominantly male (76 %), with the largest representation from Denmark (82 %), and primarily educated as physicians (62 %). A majority of respondents (73 % [95 % CI: 70 to 76 %]) did not support that supplemental oxygen should always be provided to all severely injured trauma patients without consideration of their arterial oxygen saturation as measured by pulse oximetry (SpO2), with no significant difference between physicians and non-physicians (p = 0.08). Based on the respondents' preferred dosages, the median initial administered dosage of supplemental oxygen for spontaneously breathing trauma patients with a normal SpO2 in the first few hours after trauma was 0 (interquartile range [IQR] 0-3) litres per minute, with 58 % of respondents opting not to provide any supplemental oxygen. The lowest acceptable SpO2 goal in the first few hours after trauma was 94 % (IQR 92-95). In clinical scenarios with TBI, higher dosage of supplemental oxygen and fraction of inspired oxygen (FiO2) were preferred, as well as targeting partial pressure of oxygen in arterial blood as opposed to adjusting the FiO2 directly, compared to no TBI. Conclusion: Almost three out of four clinicians did not support the administration of supplemental oxygen to all severely injured trauma patients, regardless of SpO2. This corresponds to a more restrictive approach than recommended in the current ATLS (2018, 10th ed.) guidelines.

引用

页数：8

共 50 条

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