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Title: Conservative or liberal oxygen therapy for mechanically ventilated adults with acute brain pathologies: A post-hoc subgroup analysis.
Austin Authors: Young, Paul J;Mackle, Diane;Hodgson, Carol;Bellomo, Rinaldo ;Bailey, Michael;Beasley, Richard;Deane, Adam M;Eastwood, Glenn M ;Finfer, Simon;Freebairn, Ross;King, Victoria;Linke, Natalie;Litton, Edward;McArthur, Colin;McGuinness, Shay;Panwar, Rakshit
Affiliation: Intensive Care
Intensive Care Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia..
School of Public Health, Imperial College London, London, England, UK..
Intensive Care Unit, John Hunter Hospital, New Lambton Heights, New South Wales, Australia..
School of Medicine and Public Health, University of Newcastle, Newcastle, Australia..
Critical Care Division and Trauma, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia..
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia..
University of Melbourne, Parkville, Victoria, Australia..
Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia..
Intensive Care Unit, Wellington Hospital, Wellington, New Zealand..
Medical Research Institute of New Zealand, Wellington, New Zealand..
Intensive Care Unit, Hawkes Bay Hospital, Hastings, New Zealand..
Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand..
Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand..
Issue Date: 2-Jun-2022
Date: 2022
Publication information: Journal of Critical Care 2022; 71:154079
Abstract: 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.
DOI: 10.1016/j.jcrc.2022.154079
ORCID: 0000-0002-1650-8939
Journal: Journal of critical care
PubMed URL: 35660843
PubMed URL:
Type: Journal Article
Subjects: Hyperoxia
Oxygen therapy
Subarachnoid hemorrhage
Traumatic brain injury
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