{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T18:48:30Z","timestamp":1785782910824,"version":"3.56.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Mechanically ventilated patients in the intensive care unit (ICU) are often managed to maximize oxygenation, yet hyperoxemia may be deleterious to some. Little is known about how ICU providers weigh tradeoffs between hypoxemia and hyperoxemia when managing acute respiratory failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To define ICU providers\u2019 mental models for managing oxygenation for patients with acute respiratory failure and identify barriers and facilitators to conservative oxygen therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In two large U.S. tertiary care hospitals, we performed semistructured interviews with a purposive sample of ICU nurses, respiratory therapists, and physicians. We assessed perceptions of oxygenation management, hyperoxemia, and conservative oxygen therapies through interviews, which we audio recorded and transcribed verbatim. We analyzed transcripts for representative themes using an iterative thematic-analysis approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We interviewed 10 nurses, 10 respiratory therapists, 4 fellows, and 5 attending physicians before reaching thematic saturation. Major themes included perceptions of hyperoxemia, attitudes toward conservative oxygen therapy, and aspects of titrated-oxygen-therapy implementation. Many providers did not recognize the term \u201chyperoxemia,\u201d whereas others described a poor understanding; several stated they never encounter hyperoxemia clinically. Concerns about hyperoxemia varied: some providers believed that typical ventilation strategies emphasizing progressive lowering of the fraction of inspired oxygen mitigated worries about excess oxygen administration, whereas others maintained that hyperoxemia is harmful only to patients with chronic lung disease. Almost all interviewees expressed familiarity with lower oxygen saturations in chronic obstructive pulmonary disease. Cited barriers to conservative oxygen therapy included concerns about hypoxemia, particularly among nurses and respiratory therapists; perceptions that hyperoxemia is not harmful; and a lack of clear evidence supporting conservative oxygen therapy. Interviewees suggested that interprofessional education and convincing clinical trial evidence could facilitate uptake of conservative oxygenation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study describes attitudes toward hyperoxemia and conservative oxygen therapy. These preferences and uncertain benefits and risks of conservative oxygen therapy should be considered during future implementation efforts. Successful oxygen therapy implementation most likely will require 1) improving awareness of hyperoxemia\u2019s effects, 2) normalizing lower saturations in patients without chronic lung disease, 3) addressing ingrained beliefs regarding oxygen management and oxygen\u2019s safety, and 4) using interprofessional education to obtain buy-in across providers and inform the ICU team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.202007-802oc","type":"journal-article","created":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T17:15:32Z","timestamp":1608225332000},"page":"1369-1379","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":7,"title":["Perceptions of Hyperoxemia and Conservative Oxygen Therapy in the Management of Acute Respiratory Failure"],"prefix":"10.1093","volume":"18","author":[{"given":"Brett R.","family":"Curtis","sequence":"first","affiliation":[{"name":"Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly J.","family":"Rak","sequence":"additional","affiliation":[{"name":"Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Richardson","sequence":"additional","affiliation":[{"name":"Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey","family":"Linstrum","sequence":"additional","affiliation":[{"name":"Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy M.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine"},{"name":"Department of Medicine, School of Medicine"},{"name":"Department of Health Policy and Management, Graduate School of Public Health, and"},{"name":"Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9833-4871","authenticated-orcid":false,"given":"Timothy D.","family":"Girard","sequence":"additional","affiliation":[{"name":"Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine"},{"name":"Department of Medicine, School of Medicine"},{"name":"Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,1]]},"reference":[{"key":"2026012203491592700_bib1","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1001\/jama.2016.11993","article-title":"Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial","volume":"316","author":"Girardis","year":"2016","journal-title":"JAMA"},{"key":"2026012203491592700_bib2","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1056\/NEJMoa1916431","article-title":"Liberal or conservative oxygen therapy for acute respiratory distress syndrome","volume":"382","author":"Barrot","year":"2020","journal-title":"N Engl J Med"},{"key":"2026012203491592700_bib3","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1164\/rccm.201505-1019OC","article-title":"Conservative versus liberal oxygenation targets for mechanically ventilated patients: a pilot multicenter randomized controlled trial","volume":"193","author":"Panwar","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012203491592700_bib4","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1007\/s00134-018-5232-7","article-title":"Conservative versus liberal oxygenation targets in critically ill children: the randomised multiple-centre pilot Oxy-PICU trial","volume":"44","author":"Peters","year":"2018","journal-title":"Intensive Care Med"},{"key":"2026012203491592700_bib5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1177\/1479972314562408","article-title":"How do health-care professionals perceive oxygen therapy? 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