1099: Relationship Between Inspired Oxygen Concentration and Atelectasis Formation After Extubation

Ishii, Kenzo; Morimatsu, Hiroshi; Hyodo, Tsuyoshi; Ono, Kazumi; Hidaka, Hidekuni; Koyama, Yusuke; Fujishige, Aki; Arai, Maya; Kosaka, Mako; Okazaki, Nobuki; Sakura, Takanobu; Takenaka, Shiho; Yokoo, Chikako; Yajima, Yuuta; K, Kimura; Oomura, Hiroyuki; Kimura, Yuka; Sato, Masuya

doi:10.1097/01.ccm.0000529104.66235.9e

Cited by 5 publications

(4 citation statements)

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“…Eleven RCTs did not report any outcome of interest [8][9][10]12,13,[49][50][51][52][53][54] ; six trials were included in the quantitative analysis. 11,[37][38][39][40]55 The number of participants ranged from 34 to 2928, and all RCTs included adults admitted to the ICU: nine trials included multidisciplinary ICU patients [8][9][10][11][12][13]51,52 ; four trials included only medical ICU patients 37,38,40,54 ;…”

Section: Characteristics Of Included Trialsmentioning

confidence: 99%

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Long‐term effects of lower versus higher oxygenation levels in adult ICU patients—A systematic review

Crescioli

Krejberg

Klitgaard

et al. 2022

Acta Anaesthesiol Scand

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Background Oxygen therapy is a common treatment in the intensive care unit (ICU) with both potentially desirable and undesirable long‐term effects. This systematic review aimed to assess the long‐term outcomes of lower versus higher oxygenation strategies in adult ICU survivors. Methods We included randomised clinical trials (RCTs) comparing lower versus higher oxygen supplementation or oxygenation strategies in adults admitted to the ICU. We searched major electronic databases and trial registers. We included all non‐mortality long‐term outcomes. Prespecified co‐primary outcomes were the long‐term cognitive function measures, the overall score of any valid health‐related quality of life (HRQoL) evaluation, standardised 6‐min walk test, and lung diffusion capacity. The protocol was published and prospectively registered in the PROSPERO database (CRD42021223630). Results The review included 17 RCTs comprising 6592 patients, and six trials with 825 randomised patients reported one or more outcomes of interest. We observed no difference in cognitive evaluation via Telephone Interview for Cognitive Status (one trial, 409 patients) (mean score: 30.6 ± 4.5 in the lower oxygenation group vs. 30.4 ± 4.3 in the higher oxygenation group). The trial was judged at overall high risk of bias and the certainty of evidence was very low. Any difference was neither observed in HRQoL measured via EuroQol 5 dimensions 5 level questionnaire and EQ Visual Analogue Score (one trial, 499 patients) (mean score: 70.1 ± 22 in the lower oxygenation group vs. 67.6 ± 22.4 in the higher oxygenation group). The trial was judged as having high risk of bias, the certainty of evidence was very low. No trial reported neither the standardised 6‐min walk test nor lung diffusion test. Conclusion The evidence is very uncertain about the effect of a lower versus a higher oxygenation strategy on both the cognitive function and HRQoL. A lower versus a higher oxygenation strategy may have a little to no effect on both outcomes but the certainty of evidence is very low. No evidence was found for the effects on the standardised 6‐min walking test and diffusion capacity test.

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Section: Characteristics Of Included Trialsmentioning

confidence: 99%

“…and two trials included only surgical ICU patients. 49,55 Two trials did not report the type of ICU to which patients were admitted. 39,50 The trials were conducted across different countries in Europe, Asia, Australia, and New Zealand.…”

Section: Characteristics Of Included Trialsmentioning

confidence: 99%

Long‐term effects of lower versus higher oxygenation levels in adult ICU patients—A systematic review

Crescioli

Krejberg

Klitgaard

et al. 2022

Acta Anaesthesiol Scand

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“…Suzuki et al 21 estimated atelectasis as time-weighted averages, and also found a beneficial effect of a low FiO 2 . In the study by Ishii et al 18 additional information on intubated patients were found in an abstract 27 from the same study. They found a higher incidence of atelectasis in the high FiO 2 group, but the total number of patients was not reported.…”

Section: Atelectasismentioning

confidence: 99%

“…Of these three, one 8 measured areas of atelectasis in cm 2 whereas the two others 15 25 measured if atelectases were present or not. Ishii et al 18 also used CT-scans, but defined atelectases as areas with formation of more than 10 mm thick atelectasis from the first to the second scan. The study by Staehr et al 25 did not define specific criteria on when densities were judged as atelectasis or not.…”

Section: Random Sequence Generationmentioning

confidence: 99%

Determining a safe upper limit of oxygen supplementation for adult patients: a systematic review

et al. 2021

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ObjectiveThis systematic review aimed to describe the connection between the inspired oxygen fraction and pulmonary complications in adult patients, with the objective of determining a safe upper limit of oxygen supplementation.MethodsMEDLINE and Embase were systematically searched in August 2019 (updated July 2020) for studies fulfilling the following criteria: intubated adult patients (Population); high fractions of oxygen (Intervention) versus low fractions of (Comparison); atelectasis, acute respiratory distress syndrome (ARDS), pneumonia and/or duration of mechanical ventilation (Outcome); original studies both observational and interventional (Studies). Screening, data extraction and risk of bias assessment was done by two independent reviewers.ResultsOut of 6120 records assessed for eligibility, 12 were included. Seven studies were conducted in the emergency setting, and five studies included patients undergoing elective surgery. Eight studies reported data on atelectasis, two on ARDS, four on pneumonia and two on duration of mechanical ventilation. There was a non-significant increased risk of atelectasis if an oxygen fraction of 0.8 or above was used, relative risk (RR): 1.37 (95% CI 0.95 to 1.96). One study showed an almost threefold higher risk of pneumonia in the high oxygen fraction group (RR: 2.83 (95% CI 2.25 to 3.56)). The two studies reporting ARDS and the two studies with data on mechanical ventilation showed no association with oxygen fraction. Four studies had a high risk of bias in one domain.ConclusionsIn this systematic review, we found inadequate evidence to identify a safe upper dosage of oxygen, but the identified studies suggest a benefit of keeping inspiratory oxygen fraction below 0.8 with regard to formation of atelectases.PROSPERO registration numberCRD42020154242.

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Higher versus lower fraction of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit

Barbateskovic

Schjørring

Krauss³

et al. 2019

Cochrane Database of Systematic Reviews

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1099: Relationship Between Inspired Oxygen Concentration and Atelectasis Formation After Extubation

Cited by 5 publications

References 0 publications

Long‐term effects of lower versus higher oxygenation levels in adult ICU patients—A systematic review

Long‐term effects of lower versus higher oxygenation levels in adult ICU patients—A systematic review

Determining a safe upper limit of oxygen supplementation for adult patients: a systematic review

Higher versus lower fraction of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit

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