The paramount parameter: arterial oxygen tension versus arterial oxygen saturation as target in trials on oxygenation in intensive care

Excerpt

Oxygenation targets in critically ill patients admitted to the intensive care unit (ICU), in particular in patients with acute hypoxaemic respiratory failure, are still a matter of debate. There is mounting evidence for potential harm through hyperoxia [1‐3]. Nevertheless, the optimal oxygenation targets, which minimise hyperoxia while maintaining sufficient oxygenation to avoid harm through hypoxia, remain unclear. Therefore, larger randomised clinical trials on the subject are needed. Several observational studies [4] as well as interventional before-and-after trials [1, 5] and three small randomised controlled trials [2, 3, 6] have added valuable, although not definitive, evidence to the field. Arterial oxygen saturation (SaO₂) or pulse oximetry (SpO₂) has been the primary parameter defining the target range in most of the interventional studies conducted. We would like to dispute this preference of SaO₂ and SpO₂ over arterial oxygen tension (PaO₂) as the target parameter. Hence, this proposition for debate. …