Are we harming patients with oxygen?
This will offend many in the oxygen religion, but we should start thinking of oxygen overdose.
What is our use of oxygen for everything based on?
Received wisdom from authority figures. We need to stop using authority and tradition as excuses to harm people.
Then reconsider your answer to my question.
Are we overdosing our patients, when we raise their oxygen saturation to 100%?
What if the origin sat was 94%?
What if the origin sat was 74%?
What if the origin sat was 54%?
Does the original oxygen saturation matter?
Would we have the same worries if the drug (oxygen is a drug) is morphine, NTG, midazolam, or even amiodarone?
Why do we grant the beliefs of the religion of oxygen such immunity from examination?
According to Mike McEvoy, the goal is 92% to 96%.
98% is worse.
99% is much worse.
100% is as bad as it can get – even worse than hypoxia.
A couple of points. Mike McEvoy states that the intensive care community has been familiar with this since the 1990s. This has been studied, and there has been evidence of harm since at least as early as 1950.
The administration of 100 per cent oxygen may actually be contraindicated in patients in whom oxygen saturation of arterial blood is normal.
This was a decade before we found out that internal mammary artery ligation is nothing more than a placebo surgery. That extremely popular procedure was done away with so quickly, that few people even remember the use of internal mammary artery ligation as a treatment for angina?
Oxygen has tradition behind it encouraging us to keep killing patients.
We should have been smart enough to reconsider our devotion to received wisdom and authority in 1950.
Many of us still refuse to learn.
This is why we need evidence before applying treatments to everyone.
How many hundreds of thousands of patient have we killed with oxygen and our refusal to require evidence of improved outcomes?
 One hundred percent oxygen in the treatment of acute myocardial infarction and severe angina pectoris.
RUSSEK HI, REGAN FD, NAEGELE CF.
J Am Med Assoc. 1950 Sep 30;144(5):373-5. No abstract available.
PMID: 14774103 [PubMed – indexed for MEDLINE]
In five patients with angina pectoris the administration of 100 per cent oxygen did not favorably influence the onset or duration of pain or the electrocardiographic alterations induced by standard exercise. On the contrary, oxygen therapy actually appeared responsible for more pronounced and persistent electrocardiographic changes in several patients.
 An evaluation of internal-mammary-artery ligation by a double-blind technic.
COBB LA, THOMAS GI, DILLARD DH, MERENDINO KA, BRUCE RA.
N Engl J Med. 1959 May 28;260(22):1115-8. No abstract available.
PMID: 13657350 [PubMed – indexed for MEDLINE]