Hiperoxemia na admissão na unidade de terapia intensiva em pacientes críticos agudos admitidos por motivo clínico: incidência e associação com a mortalidade hospitalar

Abstract

Introduction: Hyperoxemia is frequently neglected in critically ill patients. This study primarily aimed to evaluate the incidence of hyperoxemia at ICU admission in nonsurgical critically ill patients and its association with hospital mortality. Methods: A prospective cohort study including 3088 consecutive nonsurgical patients >18 years admitted to an intensive care unit (ICU) in Brazil from July/2018 to June/2021. Hyperoxemia was classified as PaO2 <120 mmHg at ICU admission. Results: Hyperoxemia was observed in 1174 patients (38.0%). Age (OR: 1.019, 95% CI 1.015– 1.023, p < 0.001), and chronic kidney disease (OR: 1.551, 95% CI: 1.017–2.365, p = 0.041) were associated with a high rate of hyperoxemia, while SOFA (OR: 0.881, 95% CI: 0.834–0.930, p < 0.001), late-night admission (OR: 0.799, 95% CI: 0.666–0.958, p = 0.015), renal/metabolic (OR: 0.225, 95% CI: 0.009–0.054, p < 0.001), neurological (OR: 0.022, 95% CI: 0.009–0.054, p < 0.001), digestive (OR: 0.227, 95% CI: 0.126– 0.411, p < 0.001), and soft tissue/skin/orthopedic (OR: 0.325, 95%CI: 0.133–0.792, p = 0.013) primary reasons for hospital admission were associated with a low rate of hyperoxemia. Hyperoxemia was independently associated with hospital mortality (OR: 1.317, 95% CI: 1.038–1.672, p = 0.023). Conclusion: Hyperoxemia was frequently at ICU admission. Early hyperoxemia already on admission to the ICU was associated with increased hospital mortality. Considering hyperoxemia risks and unnecessary costs, health care professionals should be aware of this condition.