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Title: Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: a retrospective nested cohort study
Austin Authors: Eastwood, Glenn M ;Tanaka, Aiko;Espinoza, Emilo Daniel Valenzuela;Peck, Leah ;Young, Helen ;Mårtensson, Johan;Zhang, Ling;Glassford, Neil J;Hsiao, Yu-Feng Frank;Suzuki, Satoshi;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia
ANZIC-RC, Monash University, Victoria, Australia
Department of Anesthesiology and Intensive Care, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
Section of Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
Department of Nephrology, West China Medical School, West China Hospital, China
Issue Date: Apr-2016 2015-10-21
Publication information: Resuscitation 2016; 101: 108-114
Abstract: BACKGROUND: In mechanically ventilated (MV) cardiac arrest (CA) survivors admitted to the intensive care unit (ICU) avoidance of hypoxia is considered crucial. However, avoidance of hyperoxia may also be important. A conservative approach to oxygen therapy may reduce exposure to both. METHODS: We evaluated the introduction of conservative oxygen therapy (target SpO2 88-92% using the lowest FiO2) during MV for resuscitated CA patients admitted to the ICU. RESULTS: We studied 912 arterial blood gas (ABG) datasets: 448 ABGs from 50 'conventional' and 464 ABGs from 50 'conservative' oxygen therapy patients. Compared to the conventional group, conservative group patients had significantly lower PaO2 values and FiO2 exposure (p<0.001, respectively); more received MV in a spontaneous ventilation mode (18% vs 2%; p=0.001) and more were exposed to a FiO2 of 0.21 (19 vs 0 patients, p=0.001). Additionally, according to mean PaO2, more conservative group patients were classified as normoxaemic (36 vs 16 patients, p<0.01) and fewer as hyperoxaemic (14 vs 33 patients, p<0.01). Finally, ICU length of stay was significantly shorter for conservative group patients (p=0.04). There was no difference in the proportion of survivors discharged from hospital with good neurological outcome (14/23 vs 12/22 patients, p=0.67). CONCLUSIONS: Our findings provide preliminary support for the feasibility and physiological safety of conservative oxygen therapy in patients admitted to ICU for MV support after cardiac arrest (Trial registration, NCT01684124).
DOI: 10.1016/j.resuscitation.2015.11.026
PubMed URL:
Type: Journal Article
Subjects: Oxygen
Cardiac arrest
Mechanical ventilation
Intensive care
Appears in Collections:Journal articles

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