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What’s the Ideal SpO2 Range in Critically Ill Patients?

November 14, 2019

Written by Clay Smith

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The ideal range of SpO2 associated with the lowest mortality in critically ill patients in this large, retrospective study was 94-98%.

Why does this matter?
Low SpO2 is bad. But too much oxygen is also bad. What’s the ideal range in critically ill patients?

SpO2 sweet spot
Two large databases were queried for median SpO2 to determine an ideal range, and they determined duration of time in that ideal range and association with mortality. There were 26,723 patients in one database (eICU-CRD) and 8,564 in the other (MIMIC). In each database, 94-98% was the ideal range, and the duration of time in that range was associated with the lowest adjusted mortality. When patients spent 80% of time in the ICU in the ideal range vs just 40%, odds of death dropped by 58% in the eICU-CRD cohort and 47% in MIMIC cohort: OR 0.42 (95%CI 0.40-0.43) in eICU-CRD; 0.53 (95%CI 0.50-0.55) in MIMIC.

The Search for Optimal Oxygen Saturation Targets in Critically Ill Patients: Observational Data From Large ICU Databases. Chest. 2019 Oct 4. pii: S0012-3692(19)33943-1. doi: 10.1016/j.chest.2019.09.015. [Epub ahead of print]

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