Hyperoxia in the intensive care unit

Why more is not always better

William A. Altemeier, Scott Sinclair

Research output: Contribution to journalReview article

142 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: Hyperoxic inspired gas is essential for patients with hypoxic respiratory failure; it is also suspected, however, as a contributor to the pathogenesis of acute lung injury. Several recent studies in humans, animals, and cell culture have identified mechanisms by which hyperoxia may exert deleterious effects on critically ill patients. This review identifies relevant new findings regarding hyperoxic lung injury in the context of providing guidance for future clinical studies. RECENT FINDINGS: Recent studies have clarified the roles of both receptor-mediated and mitochondrial cell death pathways in experimental hyperoxic lung injury. Studies in animals demonstrate that hyperoxia interacts with mechanical stretch to augment ventilator-induced lung injury. Finally, studies in humans implicate hyperoxia in impairment of host defense responses to infections. SUMMARY: Although hyperoxia has not been conclusively identified as a clinically important cause of lung injury in humans, animal data strongly implicate it. Reports of interaction effects between hyperoxia and both mechanical ventilation and host defense suggest that clinical studies of hyperoxia must take these variables into account. Accumulating data about how hyperoxia initiates cell death provide guidance for development of both biomarkers to identify hyperoxia-induced injury and pharmacological interventions to limit hyperoxia's adverse effects.

Original languageEnglish (US)
Pages (from-to)73-78
Number of pages6
JournalCurrent Opinion in Critical Care
Volume13
Issue number1
DOIs
StatePublished - Feb 2007

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Hyperoxia
Intensive Care Units
Lung Injury
Cell Death
Ventilator-Induced Lung Injury
Acute Lung Injury
Artificial Respiration
Critical Illness
Respiratory Insufficiency
Cell Culture Techniques
Biomarkers
Gases
Pharmacology

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Hyperoxia in the intensive care unit : Why more is not always better. / Altemeier, William A.; Sinclair, Scott.

In: Current Opinion in Critical Care, Vol. 13, No. 1, 02.2007, p. 73-78.

Research output: Contribution to journalReview article

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