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Updated: Feb 6, 2026
Mechanical Ventilation Boot Camp Curriculum
Published on: March 12, 2018
The Association between Arterial Oxygen Tension, Hemoglobin Concentration, and Mortality in Mechanically Ventilated
Mahesh Ramanan1,2, Nick Fisher3
1Department of Intensive Care Medicine, Redcliffe, Caboolture and Prince Charles Hospitals, QLD, Australia.
Background:
Hypoxemia and anemia are common findings in critically ill patients admitted to Intensive Care Units. Both are independently associated with significant morbidity and mortality. However, the interaction between oxygenation and anemia and their impact on mortality in critically ill patients has not been clearly defined. We undertook this study to determine whether hemoglobin (Hb) level would modify the association between hypoxemia and mortality in mechanically ventilated critically ill patients.
Methods:
We performed a retrospective cohort study of all mechanically ventilated adult patients (aged >16 years) in the Australian and New Zealand Intensive Care Society Adult Patient Database (APD) admitted over a 10-year period. Multivariate hierarchical logistic regression was used to assess the relationship between hypoxemia and hospital mortality stratified by Hb.
Results:
Of 1,196,089 patients in the APD, 219,723 satisfied our inclusion and exclusion criteria. There was a linear negative relationship between hypoxemia and hospital mortality which was significantly modified when stratified by Hb. Hb independently increased the risk of mortality in patients with arterial oxygen tension <102.
Conclusions:
Hb is an effect modifier on the association between oxygenation and mortality.
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