Details

Autor(en) / Beteiligte

• Young, Paul J.
• Mackle, Diane
• Hodgson, Carol
• Bellomo, Rinaldo
• Bailey, Michael
• Beasley, Richard
• Deane, Adam M.
• Eastwood, Glenn
• Finfer, Simon
• Freebairn, Ross
• King, Victoria
• Linke, Natalie
• Litton, Edward
• McArthur, Colin
• McGuinness, Shay
• Panwar, Rakshit

Titel

Conservative or liberal oxygen therapy for mechanically ventilated adults with acute brain pathologies: A post-hoc subgroup analysis

Ist Teil von

• Journal of critical care, 2022-10, Vol.71, p.154079-154079, Article 154079

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2022

Quelle

ScienceDirect

Beschreibungen/Notizen

• To compare the effect of conservative vs. liberal oxygen therapy in mechanically ventilated adults in the intensive care unit (ICU) with non-hypoxic ischemic encephalopathy (HIE) acute brain pathologies. Post-hoc analysis of data from 217 patients with non-HIE acute brain pathologies included in the ICU Randomized Trial Comparing Two Approaches to OXygen therapy (ICU-ROX). Patients allocated to conservative oxygen spent less time with oxygen saturation ≥ 97% (50.5 [interquartile range (IQR), 18.5–119] vs. 82 h [IQR, 38–164], absolute difference, −31.5 h; 95%CI, −59.6 to −3.4). At 180 days, 38 of 110 conservative oxygen patients (34.5%) and 28 of 104 liberal oxygen patients (26.9%) had died (absolute difference, 7.6 percentage points; 95%CI, −4.7 to 19.9 percentage points; P = 0.23; interaction P = 0.02 for non-HIE acute brain pathologies vs. HIE; interaction P = 0.53 for non-HIE acute brain pathologies vs. non-neurological conditions). In this post-hoc analysis, patients admitted to the ICU with non-HIE acute brain pathologies treated with conservative oxygen therapy did not have significantly lower mortality than those treated with liberal oxygen. A trial with adequate statistical power is needed to determine whether our day 180 mortality point estimate of treatment effect favoring liberal oxygen therapy indicates a true effect. •Patients with severe acute brain pathologies often receive oxygen therapy in the ICU for many days.•We did a post-hoc analysis of non-hypoxic ischemic encephalopathy acute brain pathology patients in the ICU-ROX trial.•Observed day 180 mortality rates were 7.6 percent points lower in patients allocated to liberal oxygen.•A trial with adequate statistical power is needed to determine if this finding indicates a true effect.