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Oxygen delivery to patients after cardiac surgery : a medical record audit

Eastwood, Glenn M, O'Connell, Bev and Considine, Julie 2009, Oxygen delivery to patients after cardiac surgery : a medical record audit, Critical care and resuscitation, vol. 11, no. 4, pp. 238-243.

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Title Oxygen delivery to patients after cardiac surgery : a medical record audit
Author(s) Eastwood, Glenn M
O'Connell, Bev
Considine, JulieORCID iD for Considine, Julie orcid.org/0000-0003-3801-2456
Journal name Critical care and resuscitation
Volume number 11
Issue number 4
Start page 238
End page 243
Total pages 6
Publisher Australasian Medical Publishing Company
Place of publication Bedford Park, S. A.
Publication date 2009
ISSN 1441-2772
Summary OBJECTIVE: To describe how intensive care nurses manage the administration of supplemental oxygen to patients during the first 24 hours after cardiac surgery.
METHODS: A retrospective audit was conducted of the medical records of 245 adult patients who underwent cardiac surgery between 1 January 2005 and 31 May 2008 in an Australian metropolitan hospital. Physiological data (oxygen saturation measured by pulse oximetry and respiratory rate) and intensive care unit management data (oxygen delivery device, oxygen flow rate and duration of mechanical ventilation) were collected at hourly intervals over the first 24 hours of ICU care.
RESULTS: Of the 245 patients whose records were audited, 185 were male; mean age was 70 years (SD, 10), and mean APACHE II score was 17.5 (SD, 5.14). Almost half the patients (122, 49.8%) were extubated within 8 hours of ICU admission. The most common oxygen delivery device used immediately after extubation was the simple face mask (214 patients, 87%). Following extubation, patients received supplemental oxygen via, on average, two different delivery devices (range, 1-3), and had the delivery device changed an average of 1.38 times (range, 0-6) during the 24 hours studied. Twenty-two patients (9%) received non-invasive ventilation or high-flow oxygen therapy, and 16 (7%) experienced one or more episode of hypoxaemia during mechanical ventilation. A total of 148 patients (60%) experienced one or more episodes of low oxygenation or abnormal respiratory rate during the first 24 hours of ICU care despite receiving supplemental oxygen.
CONCLUSION: These findings suggest that the ICU environment does not protect cardiac surgical patients from suboptimal oxygen delivery, and highlights the need for strategies to prompt the early initiation of interventions aimed at optimising blood oxygen levels in cardiac surgical patients in the ICU.
Language eng
Field of Research 111099 Nursing not elsewhere classified
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2009, Australasian Medical Publishing Company
Persistent URL http://hdl.handle.net/10536/DRO/DU:30021674

Document type: Journal Article
Collection: School of Nursing and Midwifery
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Created: Fri, 15 Jan 2010, 09:41:49 EST by Sally Morrigan

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