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- W2024100796 abstract "To the Editor: Cost effectiveness is a major concern to all in medicine. In a recent study, Oxygen Saturation in Postoperative Patients at Low Risk for Hypoxemia: Is Oxygen Therapy Needed? Gift et al. [1] conclude that patients arriving at the postanesthesia care unit (PACU) on nasal oxygen with peripheral oxygen saturation (SpO2) >92% do not need supplemental oxygen. They state, 'It does not seem cost effective in this time of diminishing resources to use oxygen-enhancing therapy to increase the oxygen saturation from one normal level to another. We found these comments surprising because all patients in this study were breathing oxygen via a nasal cannula for transport to the PACU. The only additional cost in continuing oxygen on arrival at the PACU was the oxygen itself. We had never considered the cost of oxygen a significant component in the cost of health care. This study encouraged us to see how expensive oxygen is. Our oxygen cost for 15 min of 3 L/min nasal cannula flow is approximately one penny. Arterial oxygen saturation is one consideration in the patient's delivery and utilization of oxygen. Factors such as hemoglobin concentration, medical history, cardiac output, body temperature, and oxygen consumption are also important variables in deciding the need for additional oxygen. Therefore, the use of noninvasive technology to provide oxygen therapy only to those most at risk for hypoxemia (SpO2 <92%) [1] seems ill advised during emergence from anesthesia as only one of the variables of oxygen delivery and consumption is addressed. Many postoperative patients have decreased functional residual capacity and can become hypoxic quickly. Shah et al. [2] reported a perioperative reintubation rate of 79/33,642 patients. A higher SpO2 can provide a therapeutic cushion should diagnosis of respiratory difficulty be delayed or reintubation difficult. Considering the rare but possibly devastating and expensive nature of hypoxic injuries in the PACU, the expense of approximately one penny for 15 min of oxygen may be very cost effective when larger samples of patients are evaluated. Scott B. Groudine, MD Jasvinder Singh, MD Department of Anesthesiology, Albany Medical College, Albany, NY 12208" @default.
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- W2024100796 title "Oxygen Is Cost Effective" @default.
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- W2024100796 doi "https://doi.org/10.1097/00000539-199510000-00057" @default.
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