Tissue oxygenation and routine nursing procedures in critically ill patients.

Maintaining adequate oxygenation to promote vital organ functions represents a common challenge for the critical care nurse. Critically ill patients with impaired cardiac function may be particularly vulnerable to tissue oxygen deprivation because they have limited ability to increase oxygen delivery when oxygen demands increase. Consequently, routine nursing procedures that increase oxygen requirements may have adverse effects on tissue oxygenation. Interventions that enhance patient tolerance to nursing procedures by supporting the balance between oxygen supply and demand promote physiologic adaptation and may prevent complications associated with hypoxia such as cardiac dysrhythmias, hypotension, and cardiac arrest. This discussion will focus on the principles of tissue oxygenation, the effects of nursing interventions on oxygen demand, and interventions that may enhance patient tolerance to routine nursing interventions.