Sauerstoff ist das am häufigsten verordnete Medikament im Krankenhaus. Obwohl eine
Sauerstofftherapie bei vorliegender Hypoxämie in Notfallsituationen lebensrettend
ist, sind schädigende Effekte im Sinne einer Sauerstofftoxizität bei hohen Sauerstoffkonzentrationen
bekannt. Dieser Artikel gibt einen Überblick über die aktuellen Empfehlungen zur Sauerstoffdosis
und -verabreichung.
Abstract
Oxygen treatment is being widely used in intensive care and emergency medicine and
is required to maintain aerobic metabolism. It may be administered by nasal cannula,
face mask, high-flow therapy, and by ventilation. Under clinical circumstances, blood
oxygen concentration is not relevantly increased above a partial pressure of 80 mmHg.
Although oxygen therapy is often life-saving, it has recently been shown that its
indiscriminate administration may increase morbidity and mortality, presumably due
to a formation of reactive-oxygen species.
For ventilated critically ill patients the optimal targets need to be further defined
but harm has been shown for mild hyperoxia. For patients with acute exacerbation of
chronic obstructive lung disease hyperoxia may lead to an increase of hypercarbia.
Hyperoxia may increase myocardial necrosis in myocardial infarction. For patients
with stroke, data do not show any benefit or harm from oxygen administration.
On the other hand, hyperoxia shall be used for treatment in patients with cardiac
arrest until return of spontaneous circulation and in patients with carbon monoxide
poisoning.
For other conditions, no benefit has been shown for hyperoxia, but undoubtedly, hypoxemia
must be avoided, as well. Therefore, a normoxic oxygenation strategy should be employed.
The optimal oxygenation targets for distinct conditions need to be further defined.
Schlüsselwörter - O2-Therapie - Oxygenierung - Hypoxie - Dyspnoe
Key words
O
2 therapy - oxygenation - hypoxia - dyspnea
