OXYGEN THERAPY IN HOSPITALIZED ADULTS: STATE OF THE ART
DOI:
https://doi.org/10.63330/armv1n8-008Keywords:
Oxygen, Oxygen inhalation therapy, Oxygen saturation, Hyperoxia, HypoxiaAbstract
Introduction: Oxygen therapy is one of the most fundamental and widely used medical interventions in hospital practice, ranging from primary care to complex intensive care units. Despite its apparent simplicity, oxygen represents a drug with a narrow therapeutic index, capable of causing both life-saving benefits and significant harm when mismanaged. In recent decades, robust scientific evidence has demonstrated the risks of iatrogenic hyperoxia, establishing the need for conservative and precise approaches. However, an alarming gap persists between established scientific knowledge and daily clinical practice, revealing systemic flaws that compromise patient safety and the efficiency of healthcare resources. Objective: To conduct a critical and multidimensional analysis of the state of the art of oxygen therapy in hospitalized adults, investigating its historical evolution, scientific foundations, available technologies, and the barriers that impede the translation of knowledge into safe clinical practice. Methods: Integrative review conducted through a systematic search of PubMed, EMBASE, Cochrane Library, and Scopus, with no time restriction. Randomized clinical trials, systematic reviews, meta-analyses, and guidelines from international medical societies focused on hospitalized adults were included. The analysis integrated historical sources, contemporary scientific evidence, and technological developments. Results: There is robust evidence demonstrating that conservative strategies reduce mortality compared to liberal approaches. Paradoxically, a critical gap persists between evidence and practice: only 40% of hospitals adhere to appropriate protocols. The technological analysis revealed that analog flowmeters exhibit deviations of up to 30% at high flows, constituting a fundamental barrier to guideline implementation. Digital flowmeters demonstrate accuracy of <1.5%, with a return on investment of 18–24 months and potential cost savings. Emerging technologies include high-flow nasal cannulas, automatic titration systems, and artificial intelligence for predictive medicine. Conclusions: There is a solid scientific consensus on conservative oxygen therapy, but implementation is hampered by outdated technology and a culture of complacency. Modernization to digital flowmeters and the implementation of oxygen stewardship programs are urgent imperatives to transform oxygen therapy from an imprecise art into a rigorous pharmacological science, ensuring patient safety and health system sustainability.
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