Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled
Xiaobo Yang1,2, You Shang1,2, Shiying Yuan1,2
1Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Background:
Data on the safety and feasibility of pulse oxygen saturation (SpO2) directed oxygen therapy in mainland China are scarce. The aim of this pilot study was to test the feasibility of SpO2 directed oxygen therapy and to calculate sample size base on differences in 28-day mortality rates for a large sample-sized randomized trial.
Methods:
This prospective pilot study enrolled 214 adult patients with an expected intensive care unit (ICU) stay of more than 72 hours. Patients were randomized into a low SpO2 group (SpO2 90-95%) or high SpO2 group (SpO2 96-100%). The primary outcome was 28-day mortality.
Results:
One hundred patients were included in the low SpO2 group, and 114 patients were included in the high SpO2 group. The demographic and baseline characteristics were not different. The time-weighted SpO2 average was significantly lower in the low SpO2 group than in the high SpO2 group [mean ± standard deviation (SD), 95.7%±2.3% vs. 98.2%±1.8%, P<0.001]. Twenty-six patients (26%) in the low SpO2 group died within 28 days after inclusion, while 37 patients (32.5%) in the high SpO2 group died (P=0.301). The time to death within 28 days between the two groups was not different (P=0.284).
Conclusions:
SpO2 directed oxygen therapy in critically ill patients was feasible. Our pilot trial necessitates and rationalizes our large-sample multicenter trial.
Related Concept Videos
01:24Pulse Oximetry
Purpose
Average SpO2 values are greater than 95%. If the readings fall below 90%, it indicates that...
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
01:19Guidelines For Measuring Vital Signs
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:23Physiological Control of Respiration
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...