Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study

Eastwood, Glenn M; Tanaka, Aiko; Espinoza, Emilio Daniel Valenzuela; Peck, Leah; Young, Helen; Mårtensson, Johan; Zhang, Ling; Glassford, Neil J; Hsiao, Yu Feng Frank; Suzuki, Satoshi; Bellomo, Rinaldo

doi:10.1016/j.resuscitation.2015.11.026

Cited by 41 publications

(26 citation statements)

References 34 publications

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“…This includes technological difficulties of tailoring for individual O 2 values but also missing consensus guidelines on optimal O 2 targets . Despite, novel approaches for the implementation of more conservative rather than liberal O 2 targets in ICU settings were published and appear feasible and easy to implement . One step further, Martin and Grocott et al brought up the idea of permissive hypoxemia, meaning deliberately tailoring arterial oxygenation below normally tolerated levels to avoid hyperoxia.…”

Section: Discussionmentioning

confidence: 99%

Incidence of hyperoxia and related in‐hospital mortality in critically ill patients: a retrospective data analysis

Kraft

Andel

Gamper

et al. 2017

Acta Anaesthesiol Scand

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Section: Discussionmentioning

confidence: 99%

Incidence of hyperoxia and related in‐hospital mortality in critically ill patients: a retrospective data analysis

Kraft

Andel

Gamper

et al. 2017

Acta Anaesthesiol Scand

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“…Recently, conservative oxygen therapy (target SpO 2 of 88 to 92% using the lowest FIO 2 ) has been implemented to avoid both hyperoxemia and hypoxemia and shown to be feasible and safe in several clinical settings. 14,34 Thus, potentially substantial oxygen exposure might be unnecessary, and the current study shows the need for further research. Third, the results cannot be fully applied to other countries, because this study was conducted in a single country, and our study population might be unique to Japan.…”

Section: Strengths and Limitationsmentioning

confidence: 84%

Current Ventilator and Oxygen Management during General Anesthesia

et al. 2018

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P OSTOPERATIVE pulmonary complications are common and affect morbidity and mortality in patients undergoing major surgery. 1 Intraoperative ventilation strategies for lung protection include low tidal volume, positive end-expiratory pressure (PEEP), and recruitment maneuvers. These strategies appear to improve clinical outcomes in patients undergoing major abdominal surgery. 2 However, the strategies do not consider supplemental oxygen, which is an essential component of ventilator management. Supplemental oxygen administration during mechanical ventilation is important for preventing or correcting hypoxemia, both in the intensive care unit and in the operation theater. Several observational studies of intensive care unit patients receiving mechanical ventilation found that conventional oxygen therapy was liberally administered, and this could potentially induce hyperoxemia, 3-6 which is a potentially injurious condition. High oxygen levels can enhance reactive oxygen species formation and oxidative stress, induce peripheral vasoconstriction, and decrease cardiac output. 7,8 Moreover, adverse clinical outcomes What We Already Know about This Topic • Despite the potentially harmful effects of oxygen overexposure, supplemental oxygen therapy is commonly prescribed in several clinical conditions. However, little is known about current oxygen administration practices during general anesthesia. What This Article Tells Us That Is New • In this multicenter, cross-sectional study of 1,498 patients at 43 hospitals, potentially preventable hyperoxemia and substantial oxygen exposure were common during general anesthesia, especially in patients receiving one-lung ventilation.

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“…All 6 studies compared the outcomes of conservative oxygen therapy alone with those of conventional oxygen therapy. 16,17,19−22 Three studies were randomized controlled trials (RCTs), 16,17,21 1 studies was retrospective nest cohort analysis, 19 and the other 2 studies was prospective before-after study. 20,22 Mortality was reported in 6 studies, among which hospital mortality and ICU mortality was reported in 3 studies, 16,19,20 28 day mortality was reported in 2 studies, 19,22 , 30 day mortality was reported in 1 study, 20 90 day mortality was reported in 2 studies, 17,21 180 day mortality was reported in 1 study.…”

Section: Study Descriptionmentioning

confidence: 99%

The effect of conservative oxygen therapy in reducing mortality in critical care patients: A systematic review and meta analysis

Ni¹,

Wang²,

Liang³

et al. 2020

Preprint

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Background Conservative oxygen therapy can avoid both the hypoxemia and hyperoxemia, but the effect of it on the prognosis of patients admitted to intensive care unit （ICU） remains controversial.Methods The Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled studies comparing conservative oxygen therapy and conventional oxygen therapy in adult patients admitted to ICU. The primary outcome was the mortality and the secondary outcomes were length of ICU stay (ICU LOS), length of hospital stay(hospital LOS), length of mechanical ventilation(MV) hours, new organ failure during ICU stay, new infection during ICU stay,.Results Six trials with a total of 2250 patients were pooled in our final studies. No statistical heterogeneity was found in all the analysis. Compared with conventional oxygen therapy, conservative oxygen therapy could not reduce overall mortality (Z=0.96, P=0.34), ICU LOS(Z=0.29, P=0.77)，hospital LOS(Z=1.98, P=0.05) and new infection during ICU stay (Z=0.94, P=0.35). However，conservative oxygen therapy was associated with lower MV time(Z=5.03, P<0.001) and new organ failure during ICU stay(Z=2.05, P=0.04).Conclusions Conservative oxygen therapy could not reduce the mortality but did lower the MV time and new organ failure in critically ill patients.

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Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study

Cited by 41 publications

References 34 publications

Incidence of hyperoxia and related in‐hospital mortality in critically ill patients: a retrospective data analysis

Incidence of hyperoxia and related in‐hospital mortality in critically ill patients: a retrospective data analysis

Current Ventilator and Oxygen Management during General Anesthesia

The effect of conservative oxygen therapy in reducing mortality in critical care patients: A systematic review and meta analysis

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