The Impact of a Postoperative Oxygen Therapy Protocol on use of Pulse Oximetry and Oxygen Therapy

Abstract

Background

Recent evidence suggests that both pulse oximetry monitoring and oxygen (O₂) therapy may be used inappropriately at times, implying the need for improved use of pulse oximetry by health-care providers.

Methods

We studied the clinical and financial impact of a postoperative O₂-therapy protocol in 2 groups of patients. Group 1 (n = 20) was comprised of patients whose physicians made all O₂ therapy management decisions. Group 2 (n = 20) was comprised of patients whose O₂ therapy management was performed by respiratory therapists according to an algorithm with a stop criterion of S_pO2 ≥ 92%. The duration of postoperative O₂ therapy, the frequency of unnecessary O₂ therapy, and group totals of S_pO2 measurements were compared between groups using the Mann-Whitney Rank Sum Test.

Results

O₂ therapy was used on average (SD) 3.45 (1.28) days/patient in Group 1 and 2.1 (0.64) days/patient in Group 2 (p < 0.003). Sixteen Group-1 patients continued to receive O₂ at least 24 hours after achieving a room-air S_pO2 ≥ 92%. Group 1 had 57 S_pO2 measurements and Group 2 had 24 (p < 0.003). No adverse clinical events ascribed to hypoxemia were noted in either group.

Conclusions

Our experience suggests that implementing a uniform, clinically appropriate 'stop criterion' for low-flow O₂ therapy in nonthoracic postoperative patients can shorten the duration of O₂ therapy and reduce the number of S_pO2 measurements without incurring additional complications.