Neves J T, Lobão M J
Serviço de Medicina, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
Rev Port Pneumol. 2012 Mar-Apr;18(2):80-5. doi: 10.1016/j.rppneu.2012.01.001. Epub 2012 Jan 26.
Oxygen therapy is a common and important treatment in Internal Medicine wards, however, several studies report that it isn't provided accordingly with the best of care. The goal of this work is to evaluate oxygen therapy procedures in Portuguese Internal Medicine wards, comparing them to the standards established by the British Thoracic Society (BTS) in its consensus statement "BTS guideline for emergency oxygen use in adult patients". Between September 3rd and 23rd 2010, each one of the 24 enrolled hospitals audited the oxygen therapy procedures for one randomly chosen day. All Internal Medicine inpatients under oxygen therapy or with oxygen prescription were included. Data was collected regarding oxygen prescription, administration and monitoring. Of the 1549 inpatients, 773 met inclusion criteria. There was an oxygen prescription in 93,4%. Most prescriptions were by a fixed dose (82,4%), but only 11,6% of those stated all the required parameters. Absence of oxygen therapy duration and monitoring were the most frequent errors. Oxygen was administered to only 77,0% of the patients with fixed dose prescriptions. FiO(2) or flow rate and the delivery device were the same as prescribed in 70,9 and 89,2% of the patients, respectively. Out of the 127 patients with oxygen therapy prescriptions by target SatO(2) range, 82,7% were on the prescribed SatO(2) objective range. Several errors were found in oxygen therapy procedures, particularly regarding fixed dose prescriptions, jeopardizing the patients. Although recommended by BTS, oxygen therapy prescriptions by target SatO(2) range are still a minority.
氧疗是内科病房常见且重要的治疗方法,然而,多项研究报告称,氧疗并未按照最佳护理标准进行。本研究的目的是评估葡萄牙内科病房的氧疗程序,并将其与英国胸科学会(BTS)在其共识声明《BTS成人患者紧急氧疗指南》中确立的标准进行比较。2010年9月3日至23日期间,24家参与研究的医院每家随机选择一天对氧疗程序进行审核。纳入所有接受氧疗或有吸氧处方的内科住院患者。收集了有关氧疗处方、给药和监测的数据。在1549名住院患者中,773名符合纳入标准。氧疗处方率为93.4%。大多数处方为固定剂量(82.4%),但其中只有11.6%注明了所有所需参数。最常见的错误是未注明氧疗持续时间和监测情况。在有固定剂量处方的患者中,仅77.0%接受了氧疗。分别有70.9%和89.2%的患者的吸氧浓度(FiO₂)或流速以及输送装置与处方一致。在127名根据目标血氧饱和度(SatO₂)范围开具氧疗处方的患者中,82.7%处于规定的SatO₂目标范围内。氧疗程序中发现了一些错误,特别是在固定剂量处方方面,这对患者构成了风险。尽管BTS推荐,但根据目标SatO₂范围开具的氧疗处方仍然占少数。