• Rationale and Comments

    Ideal oxygen saturation levels for patients getting supplemental oxygen therapy is at or below 96%. The overuse of supplemental oxygen has been shown to increase mortality in numerous studies of patients with a variety of critical illnesses, including cardiac arrest, stroke, and trauma, as well as after emergency surgery. Higher oxygen levels may be needed for those with certain medical conditions such as carbon monoxide poisoning or special types of headaches such as cluster headaches, sickle cell crisis, or pneumothorax. An important caveat to this recommendation is the higher incidence of occult hypoxemia, defined as an arterial oxygen saturation of less than 88% with a pulse oximetry measurement of 92% to 96%, in Black patients compared with White patients.

    Sponsoring Organizations

    • Society of Hospital Medicine – Adult Hospital Medicine

    Sources

    • Systematic review

    Disciplines

    • Pulmonary medicine

    References

    • Chu DK, Kim LH, Young PJ et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. The Lancet. 2018;391(10131):1693-1705.
    • Sjoding MW, Dickson RP, Iwashyna TJ, et al. Racial bias in pulse oximetry measurement [published correction appears in N Engl J Med. 2021;385(26):2496]. N Engl J Med. 2020;383(25):2477-2478.