Oxygenation targets in ICU patients with COVID-19: A post hoc subgroup analysis of the HOT-ICU trial
| Autor: | Minna Bäcklund, Jon Henrik Laake, Thomas Lass Klitgaard, Jørn Wetterslev, Morten H. Bestle, Olav L. Schjørring, Marjatta Okkonen, Anne Craveiro Brøchner, Matt Morgan, Mike Sharman, Klaus Marcussen, Lone Musaeus Poulsen, Martin Siegemund, Björn A. Brand, Thomas Hildebrandt, Alexa Hollinger, Bodil Steen Rasmussen, Søren R. Aagaard, Theis Lange, Tayyba N. Aslam, Christoffer Sølling, Anders Perner |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
intensive care units
medicine.medical_treatment Population Subgroup analysis 01 natural sciences law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Oxygen therapy respiratory insufficiency medicine Humans 030212 general & internal medicine 0101 mathematics education Lung Research Articles Mechanical ventilation education.field_of_study business.industry SARS-CoV-2 010102 general mathematics Oxygen Inhalation Therapy COVID-19 General Medicine Oxygenation Respiration Artificial Confidence interval 3. Good health Intensive Care Units Anesthesiology and Pain Medicine Relative risk Anesthesia randomized controlled trial business Randomised Controlled Trial Research Article severe acute respiratory syndrome coronavirus 2 |
| Zdroj: | Rasmussen, B S, Klitgaard, T L, Perner, A, Brand, B A, Hildebrandt, T, Siegemund, M, Hollinger, A, Aagaard, S R, Bestle, M H, Marcussen, K V, Brøchner, A C, Sølling, C G, Poulsen, L M, Laake, J H, Aslam, T N, Bäcklund, M, Okkonen, M, Morgan, M, Sharman, M, Lange, T, Wetterslev, J & Schjørring, O L 2022, ' Oxygenation targets in ICU patients with COVID-19: A post hoc subgroup analysis of the HOT-ICU trial ', Acta Anaesthesiologica Scandinavica, vol. 66, no. 1, pp. 76-84 . https://doi.org/10.1111/aas.13977 Rasmussen, B S, Lass Klitgaard, T, Perner, A, Brandt, B A, Hildebrandt, T, Siegemund, M, Hollinger, A, Aagaard, S R, Heiberg Bestle, M, Marcussen, K V, Craveiro Brøchner, A, Sølling, C G, Musaeus Poulsen, L, Laake, J H, Aslam, T N, Bäcklund, M, Okkonen, M, Morgan, M, Sharman, M, Lange, T, Wetterslev, J & Schjørring, O L 2022, ' Oxygenation targets in ICU patients with COVID-19: a post-hoc sub-group analysis of the HOT-ICU trial. ', Acta Anaesthesiologica Scandinavica, vol. 66, no. 1, pp. 76-84 . https://doi.org/10.1111/aas.13977 Rasmussen, B S, Klitgaard, T L, Perner, A, Brand, B A, Hildebrandt, T, Siegemund, M, Hollinger, A, Aagaard, S R, Bestle, M H, Marcussen, K V, Brøchner, A C, Sølling, C G, Poulsen, L M, Laake, J H, Aslam, T N, Bäcklund, M, Okkonen, M, Morgan, M, Sharman, M, Lange, T, Wetterslev, J & Schjørring, O L 2022, ' Oxygenation targets in ICU patients with COVID-19 : a post-hoc sub-group analysis of the HOT-ICU trial ', Acta Anaesthesiologica Scandinavica, vol. 66, no. 1, pp. 76-84 . https://doi.org/10.1111/aas.13977 Acta Anaesthesiologica Scandinavica Rasmussen, B S, Klitgaard, T L, Perner, A, Brand, B A, Hildebrandt, T, Siegemund, M, Hollinger, A, Aagaard, S R, Bestle, M H, Marcussen, K V, Brøchner, A C, Sølling, C G, Poulsen, L M, Laake, J H, Aslam, T N, Bäcklund, M, Okkonen, M, Morgan, M, Sharman, M, Lange, T, Wetterslev, J & Schjørring, O L 2022, ' Oxygenation targets in ICU patients with COVID-19 : A post hoc subgroup analysis of the HOT-ICU trial ', Acta Anaesthesiologica Scandinavica, vol. 66, no. 1, pp. 76-84 . https://doi.org/10.1111/aas.13977 |
| Popis: | Background: Supplemental oxygen is the key intervention for severe and critical COVID-19 patients. With the unstable supplies of oxygen in many countries, it is important to define the lowest safe dosage. Methods: In spring 2020, 110 COVID-19 patients were enrolled as part of the Handling Oxygenation Targets in the ICU trial (HOT-ICU). Patients were allocated within 12 h of ICU admission. Oxygen therapy was titrated to a partial pressure of arterial oxygen (PaO2) of 8 kPa (lower oxygenation group) or a PaO2 of 12 kPa (higher oxygenation group) during ICU stay up to 90 days. We report key outcomes at 90 days for the subgroup of COVID-19 patients. Results: At 90 days, 22 of 54 patients (40.7%) in the lower oxygenation group and 23 of 55 patients (41.8%) in the higher oxygenation group had died (adjusted risk ratio: 0.87; 95% confidence interval, 0.58–1.32). The percentage of days alive without life support was significantly higher in the lower oxygenation group (p = 0.03). The numbers of severe ischemic events were low with no difference between the two groups. Proning and inhaled vasodilators were used more frequently, and the positive end-expiratory pressure was higher in the higher oxygenation group. Tests for interactions with the results of the remaining HOT-ICU population were insignificant. Conclusions: Targeting a PaO2 of 8 kPa may be beneficial in ICU patients with COVID-19. These results come with uncertainty due to the low number of patients in this unplanned subgroup analysis, and insignificant tests for interaction with the main HOT-ICU trial. Trial registration number: ClinicalTrials.gov number, NCT03174002. Date of registration: June 2, 2017. |
| Databáze: | OpenAIRE |
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