To the Editor

Dr. Stemp makes an interesting point, albeit with great drama: detection of transient hypoxemia is not nearly as vital to patient outcome as determination of cause. Summarizing the logic of his letter, one would conclude that treating hypoxemia with oxygen but neglecting further investigation enables the undetected respiratory pathology to continue.

His points are legitimate. Most humans outside the hospital tolerate transient hypoxemia without sequelae as it is usually produced by a benign or self-limited process. However, hypoxemia in the hospital frequently is an early sign of impending catastrophe.

Perhaps Dr. Stemp would agree with this conclusion: oxygen should be the first step in addressing hypoxemia, but never the last.

Samuel Metz, MD
Oregon Anesthesiology Group
Portland, OR