HYPEROXIA AND OXYGEN THERAPY IN EMERGENCY CONDITIONS: DOES MORE OXYGEN ALWAYS MEAN BETTER OUTCOMES? A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6166Keywords:
Hyperoxia, Oxygen Therapy, Emergency Medicine, Critical Care, Oxidative Stress, Resuscitation, Oxygen ToxicityAbstract
Oxygen therapy remains one of the most frequently administered interventions in emergency and critical care medicine. Traditionally, supplemental oxygen has been perceived as a harmless and universally beneficial treatment for patients experiencing acute illness, trauma, or cardiorespiratory compromise. However, growing evidence accumulated over the last two decades suggests that excessive oxygen administration may be associated with adverse physiological effects and worse clinical outcomes. Hyperoxia, defined as an abnormally elevated partial pressure of oxygen in arterial blood, has emerged as an important and potentially modifiable factor in the management of critically ill patients. Numerous observational studies, randomized controlled trials, and meta-analyses have demonstrated associations between hyperoxia and increased mortality, neurological injury, oxidative stress, vasoconstriction, and organ dysfunction.
The purpose of this review is to summarize current evidence regarding the pathophysiology of hyperoxia and its clinical implications in emergency medicine and critical care. Particular emphasis is placed on acute conditions frequently encountered in emergency departments and intensive care units, including cardiac arrest, acute coronary syndromes, stroke, traumatic brain injury, sepsis, and acute respiratory failure. The review also discusses current guideline recommendations and highlights areas requiring further investigation. Contemporary evidence suggests that oxygen should be regarded as a drug requiring individualized dosing, monitoring, and titration rather than a universally beneficial intervention. Avoidance of both hypoxemia and hyperoxemia appears crucial for optimizing patient outcomes.
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