Over Use of Oxygen Therapy May Increase Risk Of Patient Death: Study

New research highlights the potential risks associated with giving patients too much oxygen while in the hospital, indicating that it may increase the risk of death. 

In a study published in the medical journal The Lancet on April 28, researchers call into question a common medical practice of offering ill patients extra oxygen. However, this practice may be contributing to more in-hospital deaths, the study concludes.

Every day, extra oxygen is given to patients around the world, the researchers warned. It is considered a safe practice that doesn’t harm the patient. Typically it is necessary for patients short of breath, those who have lung conditions, and those who are oxygen deficient; but it is offered in many other instances too.

For example, if a patient is intubated, oxygen is often administered. Intubation is when a tube is placed through the mouth into the trachea (windpipe) to help with breathing or to administer medications. Most doctors think it’s not harmful to offer extra oxygen in this case. However, the findings of the new study raise serious questions about whether this practice is a good idea.

Canadian researchers from McMaster University analyzed data from 25 different randomized control trials focusing on oxygen therapy. This was a part of the Improving Oxygen Therapy in Acute-illness (IOTA) systematic review and meta-analysis.

It included studies focusing on liberal and conservative oxygen therapy in acutely ill adults over 18 years old and involved more than 16,000 patients. The study focused on testing the widely held medical belief that oxygen therapy is not harmful, but helpful.

Conservative oxygen focuses on giving oxygen only to patients who truly need it or have trouble breathing on their own. Liberal oxygen use offers oxygen to many patients in different medical scenarios, even those without trouble breathing.

In the study, patients were treated for problems with sepsis, critical illness, stroke, trauma, myocardial infarction or cardiac arrest, and some had emergency surgery.

Researchers concluded that liberal oxygen practices increased the rates of in-hospital death, resulting in one additional fatality for every 71 patients treated with extra oxygen.

The study’s findings also indicate that giving extra oxygen to patients does not decrease the frequency of infection. The findings also indicate that extra oxygen did not decrease a patient’s length of stay in the hospital, and did not improve a patient’s level of disability. Patients who suffered strokes or brain injuries and were given oxygen during treatment did not have less disability afterward.

“Supplemental oxygen might become unfavorable above an SpO2 range of 94–96%,” the researchers wrote. “These results support the conservative administration of oxygen therapy.”

Researchers warned medical treatment should begin to move away from being too liberal with oxygen and opt for a more modest approach.

For patients who had a medical need for oxygen, frequent checks should be conducted to determine if oxygen can be decreased, the researchers recommended. Similarly, for patients who were intubated, focusing on transitioning them to room air sooner may help. Working on measures such as these may save more patient lives, they wrote.