{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T23:19:29Z","timestamp":1788477569479,"version":"build-2803163510"},"reference-count":84,"publisher":"Georg Thieme Verlag KG","funder":[{"name":"European Regional Development Funds, Fundaci\u00f3n Canaria Instituto de Investigaci\u00f3n Sanitaria de Canarias, Spain","award":["PIFIISC24\/22"],"award-info":[{"award-number":["PIFIISC24\/22"]}]},{"name":"Asociaci\u00f3n Cient\u00edfica Pulm\u00f3n y Ventilaci\u00f3n Mec\u00e1nica"},{"name":"ERAPerMed","award":["JTC_2021"],"award-info":[{"award-number":["JTC_2021"]}]},{"name":"Instituto de Salud Carlos III, Madrid, Spain","award":["CB06\/06\/1088, AC21_2\/00039"],"award-info":[{"award-number":["CB06\/06\/1088, AC21_2\/00039"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Respir Crit Care Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Oxygen is one of the most frequently used treatments in the emergency department (ED), but it should be prescribed and reassessed as an active therapy rather than left as a harmless default. Acute hypoxemia may reflect ventilation\u2013perfusion mismatch, shunt, hypoventilation, impaired oxygen transport, circulatory failure, or a combination of these mechanisms. For this reason, the response to oxygen, the choice of device, and the need for escalation depend less on the SpO2 value alone than on the physiology behind it. Current evidence has moved practice away from liberal oxygen administration and toward titration to predefined targets, aiming to correct clinically important hypoxemia while avoiding unnecessary hyperoxemia. Most acutely ill adults should receive oxygen when they are hypoxemic or clinically unstable, whereas patients at risk of hypercapnic respiratory failure, especially those with chronic obstructive pulmonary disease (COPD) exacerbation, require controlled oxygen therapy and early blood gas assessment. Conventional devices remain appropriate for many patients, but their performance varies with inspiratory demand, flow, mask fit, and entrainment of room air. High-flow nasal oxygen can improve comfort, humidification, oxygen delivery, dead-space washout, and work of breathing in select patients with acute hypoxemic respiratory failure, but preserved saturation must not delay escalation when respiratory distress, shock, altered mental status, or worsening gas exchange suggests treatment failure. Good oxygen practice in the ED means knowing when to start oxygen, how to titrate it, when to stop it, and when oxygen is not sufficient.<\/jats:p>","DOI":"10.1055\/a-2946-5854","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:31:46Z","timestamp":1787873506000},"source":"Crossref","is-referenced-by-count":0,"title":["Use of Oxygen in the Emergency Department"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9341-4899","authenticated-orcid":false,"given":"Riccardo","family":"Guglielmi","sequence":"additional","affiliation":[{"name":"General Hospital of Mother Giuseppina Vannini, Lazio, Italy","place":["Rome"],"department":["Department of Anesthesia and Intensive Care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4620-215X","authenticated-orcid":false,"given":"Antonio","family":"Campanella","sequence":"additional","affiliation":[{"name":"Fabrizio Spaziani Hospital, Lazio, Italy","place":["Frosinone"],"department":["Department of Anesthesia and Intensive Care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Villar","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Respiratorias, Instituto de Salud, Carlos III, Community of Madrid, Spain","place":["Madrid"]},{"name":"Research Unit at Hospital Universitario Dr. Negr\u00edn, Fundaci\u00f3n Canarias Instituto de Investigaci\u00f3n Sanitaria de Canarias, CN, Spain","place":["Las Palmas de Gran Canaria"]},{"name":"Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada","place":["Toronto"]},{"name":"Faculty of Health Sciences, Universidad del Atl\u00e1ntico Medio, CN, Spain","place":["Las Palmas de Gran Canaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Ferrando","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Respiratorias, Instituto de Salud, Carlos III, Community of Madrid, Spain","place":["Madrid"]},{"name":"August Pi i Sunyer Institute of Biomedical Research, Spain","place":["Barcelona"],"department":["Department of Anaesthesiology and Critical Care"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1136\/thoraxjnl-2016-209729","article-title":"BTS guideline for oxygen use in adults in healthcare and emergency settings","volume":"72","author":"B R O'Driscoll","year":"2017","journal-title":"Thorax"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1016\/S0140-6736(18)30479-3","article-title":"Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis","volume":"391","author":"D K 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