Conservative oxygen therapy in mechanically ventilated patients: a pilot before-and-after trial.

Détails

ID Serval
serval:BIB_DDB0EA8C44A2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Conservative oxygen therapy in mechanically ventilated patients: a pilot before-and-after trial.
Périodique
Critical Care Medicine
Auteur(s)
Suzuki S., Eastwood G.M., Glassford N.J., Peck L., Young H., Garcia-Alvarez M., Schneider A.G., Bellomo R.
ISSN
1530-0293 (Electronic)
ISSN-L
0090-3493
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
42
Numéro
6
Pages
1414-1422
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
OBJECTIVES: To assess the feasibility and safety of a conservative approach to oxygen therapy in mechanically ventilated ICU patients.
DESIGN: Pilot prospective before-and-after study.
SETTING: A 22-bed multidisciplinary ICU of a tertiary care hospital in Australia.
PATIENTS: A total of 105 adult (18 years old or older) patients required mechanical ventilation for more than 48 hours: 51 patients during the "conventional" before period and 54 after a change to "conservative" oxygen therapy.
INTERVENTIONS: Implementation of a conservative approach to oxygen therapy (target SpO2 of 90-92%).
MEASUREMENTS AND MAIN RESULTS: We collected 3,169 datasets on 799 mechanical ventilation days. During conservative oxygen therapy the median time-weighted average SpO2 on mechanical ventilation was 95.5% (interquartile range, 94.0-97.3) versus 98.4% (97.3-99.1) (p < 0.001) during conventional therapy. The median PaO2 was 83 torr (71-94) versus 107 torr (94-131) (p < 0.001) with a change to a median FIO2 of 0.27 (0.24-0.30) versus 0.40 (0.35-0.44) (p < 0.001). Conservative oxygen therapy decreased the median total amount of oxygen delivered during mechanical ventilation by about two thirds (15,580 L [8,263-29,351 L] vs 5,122 L [1,837-10,499 L]; p < 0.001). The evolution of the PaO2/FIO2 ratio was similar during the two periods, and there were no difference in any other biochemical or clinical outcomes.
CONCLUSIONS: Conservative oxygen therapy in mechanically ventilated ICU patients was feasible and free of adverse biochemical, physiological, or clinical outcomes while allowing a marked decrease in excess oxygen exposure. Our study supports the safety and feasibility of future pilot randomized controlled trials of conventional compared with conservative oxygen therapy.
Mots-clé
APACHE, Adult, Aged, Anoxia/prevention & control, Anoxia/therapy, Blood Gas Analysis/methods, Female, Humans, Hyperoxia/etiology, Hyperoxia/prevention & control, Intensive Care Units, Male, Middle Aged, Oxygen/administration & dosage, Oxygen/adverse effects, Oxygen Inhalation Therapy/methods, Pilot Projects, Prospective Studies, Regression Analysis, Respiration, Artificial/methods, Treatment Outcome
Pubmed
Création de la notice
26/11/2014 22:11
Dernière modification de la notice
20/08/2019 17:02
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