From the Guidelines
The target oxygen saturation (SpO2) level is 94-98% for acutely ill patients not at risk of hypercapnic respiratory failure.
Key Considerations
- For patients with known chronic obstructive pulmonary disease (COPD) or other risk factors for hypercapnic respiratory failure, a target saturation range of 88-92% is suggested pending the availability of blood gas results 1.
- The initial oxygen therapy is nasal cannulae at 2-6 L/min or simple face mask at 5-10 L/min unless stated otherwise, and the recommended initial oxygen saturation target range is 94-98% 1.
- For patients with critical illness requiring high levels of supplemental oxygen, the initial oxygen therapy is a reservoir mask at 15 L/min pending the availability of reliable oximetry readings 1.
- Administering oxygen to non-hypoxaemic patients can have potentially adverse effects, including direct pulmonary toxicity, coronary vasoconstriction, and decreased cardiac output, highlighting the importance of a physiological target saturation range to guide oxygen therapy 1.
Target Saturation Ranges
- 94-98% for acutely ill patients not at risk of hypercapnic respiratory failure 1
- 88-92% for patients with known COPD or other risk factors for hypercapnic respiratory failure pending blood gas results 1
From the Research
Target Oxygen Saturation Levels
The target oxygen saturation (SpO2) level is a critical parameter in oxygen therapy. According to various studies, the recommended target range for SpO2 varies depending on the patient's condition.
- For adult patients without COPD or other conditions associated with chronic respiratory failure, a target SpO2 range of 92-96% is recommended 2.
- For patients with COPD, a target SpO2 range of 88-92% is suggested to avoid hypercapnia 3.
- In critically ill adults receiving mechanical ventilation, oxygen-saturation targets of 90% (goal range, 88 to 92%), 94% (goal range, 92 to 96%), and 98% (goal range, 96 to 100%) have been studied, but no significant difference in clinical outcomes was found among these targets 4.
Factors Influencing Target SpO2 Levels
Several factors can influence the target SpO2 levels, including:
- Patient's underlying condition, such as COPD or chronic respiratory failure 3
- Risk of hypercapnia, which may require a lower target SpO2 range 3
- Use of mechanical ventilation, which may require different oxygen-saturation targets 4
- Patient's age and care setting, which can affect the proportion of time spent within the target SpO2 range 5
Clinical Implications
The choice of target SpO2 level can have significant clinical implications, including:
- Risk of hyperoxia, which can occur if oxygen is titrated based on SpO2 levels without consideration of the patient's underlying condition 6
- Risk of hypoxia, which can occur if the target SpO2 range is set too low 2
- Need for careful monitoring and adjustment of oxygen therapy to achieve the target SpO2 range 5