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Title: Conservative Oxygen Therapy In Mechanically Ventilated Patients Following Cardiac Arrest: A Retrospective Nested Cohort Study
Authors: Eastwood, Glenn;Tanaka, Aiko;Valenzuela, Emilio;Peck, Leah;Young, Helen;Märtensson, Johan;Zhang, Ling;Glassford, Neil;Bellomo, Rinaldo
Issue Date: 12-Oct-2015
Abstract: Aim Mechanically ventilated (MV) cardiac arrest (CA) survivors admitted to the intensive care unit (ICU) are initially typically sedated and on mandatory mechanical ventilation. While hypoxia is carefully avoided, there too are concerns over hyperoxia during the early post-resuscitation period. A conservative approach to oxygen therapy management may feasibly and safely reduce exposure to unnecessary oxygen delivery. Method We performed a retrospective nested cohort study to evaluate the introduction of a conservative approach to oxygen therapy (target SpO2 88-92% using the lowest FiO2) during the first 24 h of ICU admission for resuscitated CA patients. Results We studied 912 ABG datasets: 448 ABGs from 50 ‘conventional’ and 464 ABGs from 50 ‘conservative’ group patients. There were clear differences between the groups in relation to oxygen therapy (PaO2 and FiO2) over the first 24 hours (RM-ANOVA, p < 0.001, respectively), the use of spontaneous ventilation (1 vs 9 patients, p = 0.001), and exposure to a FiO2 of 0.21 (0 vs 19 patients, P 0.001). In addition, more conservative group patients received a spontaneous MV mode throughout the study observation (2% vs 18%; p = 0.001). We found no differences in the proportions of the patients discharged from our hospital with good neurological outcomes [CPC 1 or 2] among survivors (p = 0.67) and ICU length of stay was significantly less for conservative O2 therapy patients (p = 0.04). Conclusion Our findings provide preliminary evidence to support further investigations of conservative oxygen therapy and its impact on patient outcomes in mechanically ventilated CA patients admitted to the ICU.
Conference Name: Research Week 2015
Conference Location: Heidelberg, Victoria.
Type: Conference Paper
Subjects: Oxygen Therapy
Cardiac Arrest
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Research Week 2015

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