Pemberian Oksigen yang Tidak Pada Tempatnya Meningkatkan Mortalitas Pasien

Oleh :

dr. Catherine Ranatan

Pemberian oksigen yang tidak pada tempatnya harus dihindari karena justru menyebabkan bahaya bagi pasien. Hal ini diakibatkan oleh peningkatan reactive oxygen species yang terjadi pada penggunaan oksigen yang tidak perlu. Sudah saatnya oksigen diperlakukan sebagai obat yang membutuhkan indikasi dan dosis yang jelas.

Oksigen sering diberikan tanpa melihat tingkat saturasi oksigen pasien. Pemberian oksigen seperti ini dianggap dapat mencegah perburukan penyakit. Namun, hal ini justru disangkal oleh beberapa penelitian terbaru. Penggunaan oksigen pada penyakit akut, termasuk penggunaan pada sindrom koroner akut, yang tidak pada tempatnya justru meningkatkan mortalitas pasien.[1,2]

Sumber: J Heilman, Wikimedia commons, 2014.

Indikasi Pemberian Oksigen

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. R.A.C Semieniuk, D.K Chu, L.H.Y Kim, W. Alhazzani, et al, Oxygen therapy for acutely ill medical patients: a clinical practice guideline, 2018, 363 : k4169.
2. J. Garcia, New Guidance Recommends Minimal Oxygen for Most Inpatients, https://www.medscape.com/viewarticle/903944, 2018.
3. H.E Hatter, Z. Gater, Oxygen therapy administration in a non-emergency situation, https://www.gosh.nhs.uk/health-professionals/clinical-guidelines/oxygen-therapy-administration-non-emergency-situation, 2014.
4. College of Respiratory Therapy of Ontario, Oxygen Therapy Clinical Best Practice Guideline, http://www.crto.on.ca/pdf/PPG/Oxygen_Therapy_CBPG. pdf, 2013, 19-24.
5. B. Kane, S. Decalmer, B.R O’Driscoll, Emergency oxygen therapy: from guideline to implementation, 2013, 9, 246-253.
6. J. Pilcher, R. Beasley, Acute use of oxygen therapy, 2015,38, 98-100.
7. C. Roffe, T. Nevatte, J. Sim, et al, Effect of Routine Low-Dose Oxygen Supplementation on Death and Disability in Adults With Acute Stroke: The Stroke Oxygen Study Randomized Clinical Trial, 2017, 318 (12), 1125-35.
8. M. Girardis, et al, Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: The Oxygen-ICU randomized clinical trial, 2016, 216, 1583.
9. M. Carvalho, M. soares, H.S Machado, Paradigms of Oxygen Therapy in Critically Ill Patients, 2017, 3,1.
10. B.R O’Driscoll, L.S Howard, J Earis, et al, BTS Guidelines for Oxygen Use in Adults in Healthcare and Emergency Settings, 2017, 72: i1-i90.
11. R. Beasley, J. Chien, J. Douglas, L. Eastlake, et al, Thoracic Society of Australia and New Zealand oxygen guidelines for acute oxygen use in adults: ‘Swimming between the flags’, 2015, 20, 1182–1191.
12. D.K Chu, L.H Kim, P.J Young, et al, Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis, 2018, 391, 10131.
13. A. M Kaynar, Respiratory Failure Clinical Presentation, https://emedicine.medscape.com/article/167981-clinical#b2, 2018.
14. M. L Vold, U. Aasebo, et al, Low oxygen saturation and mortality in an adult population, 2013, 42, P4718.
15. Y. Sittichanbuncha, S.Savatmongkorngul, et al, Low oxygen saturation is associated with pre-hospital mortality among non-traumatic patients using emergency medical services: A national database of Thailand, 2015, 15 (3) 113-115.
16. R.S Majumdar, D.T Eurich, J. M Gabriel, et al, Oxygen Saturations Less than 92% Are Associated with Major Adverse Events in Outpatients with Pneumonia: A Population-Based Cohort Study, 2011, 52(3) 325 – 331.
17. S. Cunningham, A. Rodriguez, T. Adams, et al, Bronchiolitis of Infancy Discharge Study (BIDS) group. Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial, Lancet, 2015;358:1041-8.