Deliberate Oxygen Therapy – How Much Is Too Much of a Good Thing?

Oxygen is one of the most common and overused interventions in hospitals. It is a crucial component of atmospheric air, comprising approximately 21%, and is vital to numerous bodily functions and processes. While once reserved to treat and support patients with various life-threatening lung diseases, it has increasingly been routinely employed to prevent hypoxemia, particularly in the perioperative setting. In the OR, much of patient care revolves around oxygen. This includes everything from preoxygenation, to providing adequate oxygenation during the case, to oxygen uptake and delivery to vital organs, to preventing hypoxemia to reduce mortality in scenarios such as traumatic brain injury, and finally to providing sufficient oxygenation to prevent postoperative respiratory insufficiency on emergence. While oxygen is vital to life and an important element of patient care, many providers fail to recognize the harms of over-oxygenation, notwithstanding normal oxygen levels in most patients. Even though oxygen delivery in the...