The impact of a postoperative oxygen therapy protocol on use of pulse oximetry and oxygen therapy

Respir Care. 1995 Nov;40(11):1125-9.


Background: Recent evidence suggests that both pulse oximetry monitoring and oxygen (O2) therapy may be used inappropriately at times, implying the need for improved use of pulse oximetry by health-care providers.

Methods: We studied the clinical and financial impact of a postoperative O2-therapy protocol in 2 groups of patients. Group 1 (n = 20) was comprised of patients whose physicians made all O2 therapy management decisions. Group 2 (n = 20) was comprised of patients whose O2 therapy management was performed by respiratory therapists according to an algorithm with a stop criterion of SpO2 > or = 92%. The duration of postoperative O2 therapy, the frequency of unnecessary O2 therapy, and group totals of SpO2 measurements were compared between groups using the Mann-Whitney Rank Sum Test.

Results: O2 therapy was used on average (SD) 3.45 (1.28) days/patient in Group 1 and 2.1 (0.64) days/patient in Group 2 (p < 0.003). Sixteen Group-1 patients continued to receive O2 at least 24 hours after achieving a room-air SpO2 > or = 92%. Group 1 had 57 SpO2 measurements and Group 2 had 24 (p < 0.003). No adverse clinical events ascribed to hypoxemia were noted in either group.

Conclusions: Our experience suggest that implementing a uniform, clinically appropriate 'stop criterion' for low-flow O2 therapy in nonthoracic postoperative patients can shorten the duration of O2 therapy and reduce the number of SpO2 measurements without incurring additional complications.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Clinical Protocols*
  • Cost-Benefit Analysis
  • Decision Making
  • Female
  • Humans
  • Hypoxia / chemically induced
  • Male
  • Middle Aged
  • Ohio
  • Oximetry / standards*
  • Oxygen Inhalation Therapy / standards*
  • Postoperative Care / standards*
  • Recovery Room / standards
  • Time Factors