|Conservative oxygen therapy is associated with lower mortality risk in the ICU, according to an open-label study in JAMA presented at the European Society of Intensive Care Medicine’s Annual Congress.
Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, FASAM
In an Italian hospital, researchers randomized nearly 500 adult ICU patients to conservative or conventional oxygen therapy. The conservative group received the lowest possible fraction of inspired oxygen (FiO2) so that their partial pressure of oxygen (PaO2) stayed at 70–100 mm Hg or their arterial oxygen saturation (SpO2) was 94–98%. If either was exceeded, FiO2 was reduced or oxygenation stopped. In the conventional group, patients received an FiO2 of at least 0.4; Pa02 could reach 150 mm Hg and SpO2 could hit 97–100%.
Among those with an ICU stay of at least 3 days, ICU mortality was 12% with conservative oxygen versus 20% with conventional oxygen.
An editorialist points out study limitations but concludes that for now, “there appears to be little downside in the careful titration and monitoring of supplemental oxygen in the ICU to achieve physiologically normal levels of PaO2 while avoiding potentially dangerous hyperoxia.”