A quantitative assessment of how Canadian intensivists believe they utilize oxygen in the intensive care unit

Objectives: To investigate attitudes and practices regarding oxygen therapy in intensive care units (ICUs) and to devise quantitative descriptive indi ces. Setting: Canadian university-affiliated adult ICUs, Participants, Fifty-two medical directors of ICUs in 48 institutions, Intervention: Structured postal questionnaire returned by 48 participants, Measurements and Main Results: Attitudes, beliefs, and stated practices rel ating to oxygen use in ICUs were determined. Novel descriptors S-50(min) (m inutes of oxygen saturation [SaO(2)] acceptable to >50% of respondents), F- 50(max) (maximum FIO2 above which <50% of respondents would increase FIO2), and F-50(min) (minimum FIO2 below which <50% of respondents would decrease FIO2) were determined. All respondents believed that oxygen toxicity was a concern. Twenty-nine percent of respondents indicated that they did not al ways assess tissue oxygenation in critical cases. A stepwise reduction in a cceptance of progressive desaturation and increasing duration of hypoxemia was found. Presented with a stable patient with SaO(2) of 98%, the maximum level of FIO2 above which respondents stated that they would not increase t he FIO2 was 0.41 +/- 0.17 (mean +/- SD). For stable patients with SaO(2) of 85%, the minimum FIO2 below which respondents would not reduce FIO2 was 0. 59 +/- 0.23 (mean +/- SD). F-50(max) was 0.8 vs. 0.5 for SaO(2) of 80%-85% vs. 85%-90%, respectively; F-50(min) was 0.6 vs, 0.21 for SaO(2) of 90%-95% vs. 95%-100%, respectively, Conclusions, Considerable variation exists in the attitudes, beliefs, and s tated practices relating to the management of oxygen therapy in the ICU, Th ese data are amenable to quantitative description and illustrate the necess ity for documentation of actual practice and development of support systems for decisionmaking in this and similar areas.