Lower or higher oxygenation targets for acute hypoxemic respiratory failure

Autor: Olav L, Schjørring, Thomas L, Klitgaard, Anders, Perner, Jørn, Wetterslev, Theis, Lange, Martin, Siegemund, Minna, Bäcklund, Frederik, Keus, Jon H, Laake, Matthew, Morgan, Katrin M, Thormar, Søren A, Rosborg, Jannie, Bisgaard, Annette E S, Erntgaard, Anne-Sofie H, Lynnerup, Rasmus L, Pedersen, Elena, Crescioli, Theis C, Gielstrup, Meike T, Behzadi, Lone M, Poulsen, Stine, Estrup, Jens P, Laigaard, Cheme, Andersen, Camilla B, Mortensen, Björn A, Brand, Jonathan, White, Inge-Lise, Jarnvig, Morten H, Møller, Lars, Quist, Morten H, Bestle, Martin, Schønemann-Lund, Maj K, Kamper, Mathias, Hindborg, Alexa, Hollinger, Caroline E, Gebhard, Núria, Zellweger, Christian S, Meyhoff, Mathias, Hjort, Laura K, Bech, Thorbjørn, Grøfte, Helle, Bundgaard, Lars H M, Østergaard, Maria A, Thyø, Thomas, Hildebrandt, Bülent, Uslu, Christoffer G, Sølling, Nette, Møller-Nielsen, Anne C, Brøchner, Morten, Borup, Marjatta, Okkonen, Willem, Dieperink, Ulf G, Pedersen, Anne S, Andreasen, Lone, Buus, Tayyba N, Aslam, Robert R, Winding, Joerg C, Schefold, Stine B, Thorup, Susanne A, Iversen, Janus, Engstrøm, Maj-Brit N, Kjær, Bodil S, Rasmussen, P, Bhachu
Přispěvatelé: Critical Care, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
oxygen/administration & dosage
Supplemental oxygen
intensive care units
oxygen inhalation therapy/methods
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
law.invention
Hypoxia/blood
0302 clinical medicine
Randomized controlled trial
law
middle aged
Medicine
030212 general & internal medicine
Hypoxia
Respiratory Distress Syndrome
Respiratory Distress Syndrome/blood
General Medicine
Middle Aged
kaplan-meier estimate
Intensive care unit
3. Good health
Intensive Care Units
Female
Respiratory Insufficiency
medicine.medical_specialty
Respiratory Insufficiency/blood
intensive care afdeling
MEDLINE
Respiration
Artificial/methods
hypoxia/blood
ademhalingsfalen
respiratory distress syndrome/blood
03 medical and health sciences
Oxygen/administration & dosage
Respiration
Humans
ademhalingsinsufficiëntie
Aged
Acute hypoxemic respiratory failure
business.industry
respiration
artificial/methods
respiratory insufficiency/blood
Oxygen Inhalation Therapy
Oxygenation
Oxygen Inhalation Therapy/methods
Respiration
Artificial
Oxygen
artificial/methods
Multicenter study
Emergency medicine
business
respiration
Zdroj: Schjørring, O L, Klitgaard, T L, Perner, A, Wetterslev, J, Lange, T, Siegemund, M, Bäcklund, M, Keus, F, Laake, J H, Morgan, M, Thormar, K M, Rosborg, S A, Bisgaard, J, Erntgaard, A E S, Lynnerup, A S H, Pedersen, R L, Crescioli, E, Gielstrup, T C, Behzadi, M T, Poulsen, L M, Estrup, S, Laigaard, J P, Andersen, C, Mortensen, C B, Brand, B A, White, J, Jarnvig, I L, Møller, M H, Quist, L, Bestle, M H, Schønemann-Lund, M, Kamper, M K, Hindborg, M, Hollinger, A, Gebhard, C E, Zellweger, N, Meyhoff, C S, Hjort, M, Bech, L K, Grøfte, T, Bundgaard, H, Østergaard, L H M, Thyø, M A, Hildebrandt, T, Uslu, B, Sølling, C G, Møller-Nielsen, N, Brøchner, A C, Buus, L, Winding, R R & HOT-ICU Investigators 2021, ' Lower or higher oxygenation targets for acute hypoxemic respiratory failure ', New England Journal of Medicine, vol. 384, no. 14, pp. 1301-1311 . https://doi.org/10.1056/NEJMoa2032510
Schjørring, O L, Klitgaard, T L, Perner, A, Wetterslev, J, Lange, T, Siegemund, M, Bäcklund, M, Keus, F, Laake, J H, Morgan, M, Thormar, K M, Rosborg, S A, Bisgaard, J, Erntgaard, A E S, Lynnerup, A-S H, Pedersen, R L, Crescioli, E, Gielstrup, T C, Behzadi, M T, Poulsen, L M, Estrup, S, Laigaard, J P, Andersen, C, Mortensen, C B, Brand, B A, White, J, Jarnvig, I-L, Møller, M H, Quist, L, Bestle, M H, Schønemann-Lund, M, Kamper, M K, Hindborg, M, Hollinger, A, Gebhard, C E, Zellweger, N, Meyhoff, C S, Hjort, M, Bech, L K, Grøfte, T, Bundgaard, H, Østergaard, L H M, Thyø, M A, Hildebrandt, T, Uslu, B, Sølling, C G, Møller-Nielsen, N, Brøchner, A C, Borup, M, Okkonen, M, Dieperink, W, Pedersen, U G, Andreasen, A S, Buus, L, Aslam, T N, Winding, R R, Schefold, J C, Thorup, S B, Iversen, S A, Engstrøm, J, Kjær, M-B N & Rasmussen, B S 2021, ' Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure ', New England Journal of Medicine, vol. 384, no. 14, pp. 1301-1311 . https://doi.org/10.1056/NEJMoa2032510
Schjorring, O L, Klitgaard, T L, Perner, A, Wetterslev, J, Lange, T, Siegemund, M, Backlund, M, Keus, F, Laake, J H, Morgan, M, Thormar, K M, Rosborg, S A, Bisgaard, J, Erntgaard, A E S, Lynnerup, A-S H, Pedersen, R L, Crescioli, E, Gielstrup, T C, Behzadi, M T, Poulsen, L M, Estrup, S, Laigaard, J P, Andersen, C, Mortensen, C B, Brand, B A, White, J, Jarnvig, I-L, Møller, M H, Quist, L, Bestle, M H, Schonemann-Lund, M, Kamper, M K, Hindborg, M, Hollinger, A, Gebhard, C E, Zellweger, N, Meyhoff, C S, Hjort, M, Bech, L K, Grofte, T, Bundgaard, H, Ostergaard, L H M, Thyo, M A, Hildebrandt, T, Uslu, B, Solling, C G, Pedersen, U G, Andreasen, A S, Kjaer, M-B N, Rasmussen, B S & HOT-ICU Investigators 2021, ' Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure ', New England Journal of Medicine, vol. 384, no. 14, pp. 1301-1311 . https://doi.org/10.1056/NEJMoa2032510
Pedersen, U G, Andreasen, A S, Buus, L, Winding, R, Thorup, S B, Iversen, S A, Engstrøm, J, Kjaer, M-B N, Rasmussen, B S & HOT-ICU Investigators 2021, ' Lower or higher oxygenation targets for acute hypoxemic respiratory failure ', New England Journal of Medicine, vol. 384, no. 14, pp. 1301-1311 . https://doi.org/10.1056/NEJMoa2032510
The New England journal of medicine, 384(14), 1301-1311. Massachusetts Medical Society
New England Journal of Medicine, 384(14), 1301-1311. MASSACHUSETTS MEDICAL SOC
ISSN: 0028-4793
Popis: BACKGROUND Patients with acute hypoxemic respiratory failure in the intensive care unit (ICU) are treated with supplemental oxygen, but the benefits and harms of different oxygenation targets are unclear. We hypothesized that using a lower target for partial pressure of arterial oxygen (Pao 2) would result in lower mortality than using a higher target. METHODS In this multicenter trial, we randomly assigned 2928 adult patients who had recently been admitted to the ICU (≤12 hours before randomization) and who were receiving at least 10 liters of oxygen per minute in an open system or had a fraction of inspired oxygen of at least 0.50 in a closed system to receive oxygen therapy targeting a Pao 2 of either 60 mm Hg (lower-oxygenation group) or 90 mm Hg (higher-oxygenation group) for a maximum of 90 days. The primary outcome was death within 90 days. RESULTS At 90 days, 618 of 1441 patients (42.9%) in the lower-oxygenation group and 613 of 1447 patients (42.4%) in the higher-oxygenation group had died (adjusted risk ratio, 1.02; 95% confidence interval, 0.94 to 1.11; P=0.64). At 90 days, there was no significant between-group difference in the percentage of days that patients were alive without life support or in the percentage of days they were alive after hospital discharge. The percentages of patients who had new episodes of shock, myocardial ischemia, ischemic stroke, or intestinal ischemia were similar in the two groups (P=0.24). CONCLUSIONS Among adult patients with acute hypoxemic respiratory failure in the ICU, a lower oxygenation target did not result in lower mortality than a higher target at 90 days.
Databáze: OpenAIRE
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