P118 What oxygen target saturation ranges are currently prescribed for non-hypercapnic patients in UK hospitals and what target ranges would respiratory registrars prefer to use?. (11th November 2022)

• Record Type: Journal Article
• Authors: Bailey, H; Lee Evans, H; Majeed, N; Nayyar, M; O'Driscoll, BR; Palissery, V
• Is Part Of: Thorax. Volume 77(2022)Supplement 1
• Page Start: A144
• Page End: A144
• Publication Date: 2022-11-11
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2022-BTSabstracts.253
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Introduction and Objectives: The current BTS oxygen guideline recommends a target oxygen saturation range of 94–98% for acutely ill patients not at risk of hypercapnia whilst the TSANZ guideline recommends 92–96%. During the COVID-19 pandemic, the recommendation for NHS hospitals was to use a target saturation range of 92–96% for non-hypercapnic patients to conserve oxygen supplies. In the aftermath of the height of the pandemic we undertook a survey in May/June 2022 to establish what target ranges are in current use in UK hospitals and the views of respiratory health care professionals on this subject. Methods: An online questionnaire was created and distributed to respiratory registrars in the UK by email via the Specialty Training Committee representatives or Training Programme Directors. Results: 99 responses were received from 60 different NHS acute hospital trusts across the UK. 30 trusts (50%) currently use a target saturation range of 94–98% for all non-hypercapnic patients. This proportion is even higher (78%) when excluding COVID-19 patients. However, the majority of respiratory registrars who were surveyed (65%) expressed a personal preference for an alternative target saturation range, with 52% preferring target saturations of 92–96% for non-hypercapnic patients. 76% of respondents believed that too much oxygen is used in their hospital and only 1% believed that not enough oxygen is given. Conclusions: Although most UK hospitals use a target oxygen saturation range of 94–98% in the non-hypercapnic population, the preference among the respiratory registrars surveyed was for an alternative strategy (most commonly a target saturation of 92–96%). This suggests a perception among clinicians that more conservative target saturations are non-harmful to these patients, but at present the evidence supporting this is lacking. The UK-ROX and Mega-ROX trials are currently recruiting and aim to evaluate conservative versus standard oxygen saturation targets in mechanically ventilated critically ill patients. Once published these trials will hopefully give us a more concrete basis upon which to make recommendations in this important area.