Conservative Oxygenation in the ICU Reduces Mortality

Although an underpowered and prematurely-stopped trial, this study adds more evidence to the growing consensus that we have traditionally overused oxygen in many setting.  Oxygen is a medication, and not harmless.

Conservative oxygenation strategy reduces mortality in critically ill patients

Clinical Question:
Does a conservative oxygenation strategy that maintains arterial oxygen saturation within physiologic limits improve mortality of patients in the intensive care unit?

Bottom Line:
In this study, the use of conservative oxygenation goals (PaO2 70 mm Hg-100 mm Hg
and SpO2 94%-98%), as compared with higher oxygenation goals, decreased mortality in critically ill patients. However, the trial was terminated early and there was a difference in baseline illness severity between groups that could have led to an overestimation of effect size. Additionally, the trial did not reach enrollment targets and the number of
outcome events was small, which resulted in an underpowered study. The authors advise us to treat the findings as preliminary and they recommend further research. (LOE = 1b-)

Reference:
Girardis M, Busani S, Damiani E, et al. Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: The oxygen-ICU
randomized clinical trial. JAMA 2016;316(15):1583-1589.

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