The Effect of Early Severe Hyperoxia in Adults Intubated in the Prehosptial Setting or Emergency Department: A Scoping Review.

cardiac arrest early hyperoxia emergency department hyperoxia intubation mechanical ventilation trauma traumatic brain injury

Journal

The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174

Informations de publication

Date de publication:
12 2023
Historique:
received: 06 04 2023
revised: 16 07 2023
accepted: 10 08 2023
medline: 27 11 2023
pubmed: 23 10 2023
entrez: 22 10 2023
Statut: ppublish

Résumé

The detrimental effects of hyperoxia exposure have been well-described in patients admitted to intensive care units. However, data evaluating the effects of short-term, early hyperoxia exposure in patients intubated in the prehospital setting or emergency department (ED) have not been systematically reviewed. Our aim was to quantify and describe the existing literature examining the clinical outcomes in ED patients exposed to hyperoxia within the first 24 h of mechanical ventilation. This review was performed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews. Two rounds of review using Rayyan QCRI software were performed for title and abstract screening and full-text search. Of the 2739 articles, 27 articles were retrieved after initial screening, of which 5 articles were excluded during the full-text screening, leaving 22 articles for final review and data extraction. Of 22 selected publications, 9 described patients with traumatic brain injury, 6 with cardiac arrest, 3 with multisystem trauma, 1 with stroke, 2 with septic shock, and 1 was heterogeneous. Three studies were randomized controlled trials. The available data have widely heterogeneous definitions of hyperoxia exposure, outcomes, and included populations, limiting conclusions. There is a paucity of data that examined the effects of severe hyperoxia exposure in the acute, post-intubation phase of the prehospital and ED settings. Further research with standardized definitions is needed to provide more detailed guidance regarding early oxygen titration in intubated patients.

Sections du résumé

BACKGROUND
The detrimental effects of hyperoxia exposure have been well-described in patients admitted to intensive care units. However, data evaluating the effects of short-term, early hyperoxia exposure in patients intubated in the prehospital setting or emergency department (ED) have not been systematically reviewed.
OBJECTIVE
Our aim was to quantify and describe the existing literature examining the clinical outcomes in ED patients exposed to hyperoxia within the first 24 h of mechanical ventilation.
METHODS
This review was performed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews. Two rounds of review using Rayyan QCRI software were performed for title and abstract screening and full-text search. Of the 2739 articles, 27 articles were retrieved after initial screening, of which 5 articles were excluded during the full-text screening, leaving 22 articles for final review and data extraction.
RESULTS
Of 22 selected publications, 9 described patients with traumatic brain injury, 6 with cardiac arrest, 3 with multisystem trauma, 1 with stroke, 2 with septic shock, and 1 was heterogeneous. Three studies were randomized controlled trials. The available data have widely heterogeneous definitions of hyperoxia exposure, outcomes, and included populations, limiting conclusions.
CONCLUSIONS
There is a paucity of data that examined the effects of severe hyperoxia exposure in the acute, post-intubation phase of the prehospital and ED settings. Further research with standardized definitions is needed to provide more detailed guidance regarding early oxygen titration in intubated patients.

Identifiants

pubmed: 37867037
pii: S0736-4679(23)00431-6
doi: 10.1016/j.jemermed.2023.08.002
pii:
doi:

Substances chimiques

Oxygen S88TT14065

Types de publication

Systematic Review Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e495-e510

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

George Yusin (G)

Georgetown University School of Medicine, Washington, District of Columbia.

Charlotte Farley (C)

Georgetown University School of Medicine, Washington, District of Columbia.

Charles Scott Dorris (CS)

Georgetown University Medical Center, Washington, District of Columbia.

Sofiya Yusina (S)

New York University Grossman School of Medicine, New York, NY.

Saad Zaatari (S)

Georgetown University School of Medicine, Washington, District of Columbia; Department of Emergency Medicine, MedStar Health, Washington, District of Columbia.

Munish Goyal (M)

Georgetown University School of Medicine, Washington, District of Columbia; Department of Emergency Medicine, MedStar Health, Washington, District of Columbia.

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Classifications MeSH