The following is a summary of “Oxygen therapy in acute hypoxemic respiratory failure: guidelines from the SRLF-SFMU consensus conference,” published in the September 2024 issue of Critical Care by Helms et al.
Oxygen therapy and its devices have been rapidly employed for patients with acute hypoxemic respiratory failure (ARF), but the precise role and efficacy are unknown.
Researchers conducted a retrospective study to illustrate the role of oxygen and its devices in the ARF, excluding acute cardiogenic pulmonary edema and hypercapnic exacerbation of chronic obstructive diseases, via a consensus conference organized by the French Intensive Care Society (SRLF) and the French Emergency Medicine Society (SFMU) in December 2023.
They formed a committee of professionals with no conflicts of interest (CoI) to form a protocol and specified 7 generic questions with a list of sub-questions using the population, intervention, comparison, and outcomes (PICO) model. A literature review was conducted using predefined keywords, and the data was evaluated using the GRADE methodology. Answers were presented by 15 experts in a public session and responded to questions from the jury, which consisted of critical-care and emergency medicine physicians, nurses, and physiotherapists with no CoI. The jury met in private for 48 hours to draft their recommendations.
The results showed the jury provided 22 statements, answering 11 questions. In patients with ARF, they addressed measures for initiating oxygen therapy, oxygen saturation targets, role of blood gas analysis, need for an arterial catheter, preference between standard oxygen therapy, high-flow nasal cannula oxygen therapy (HFNC), and continuous positive airway pressure (CPAP), indications for non-invasive ventilation (NIV), indications for invasive mechanical ventilation, use of the awake prone position, role of physiotherapy, (criteria for ICU admission, and preferred oxygenation device for patients with a do-not-intubate decision.
They concluded these recommendations would help enhance oxygen use in patients with ARF.
Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01367-2
