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Published on: December 5, 2025

Association Between Potentially Excess Oxygen Exposure and Clinical Outcomes Among Mechanically Ventilated Children

Jamuna Rani1, Umesh Pandwar1, Navindana1

  • 1Paediatrics, Gandhi Medical College, Bhopal, Bhopal, IND.

Cureus
|July 14, 2026
PubMed

Insights

Higher oxygen exposure in mechanically ventilated children increases mortality risk and prolongs hospital stays. This study emphasizes the need for careful oxygen management in pediatric intensive care units to prevent harm.

Area of Science:

  • Pediatric Intensive Care
  • Critical Care Medicine
  • Neonatology

Background:

  • Liberal oxygen administration in pediatric intensive care may cause oxidative stress and injury.
  • Limited pediatric data exist on supraphysiological oxygen exposure's impact on mortality.
  • Prospective data are scarce, especially from low- and middle-income countries.

Purpose of the Study:

  • To assess the association between cumulative fraction of inspired oxygen (FiO₂) exposure and mortality in mechanically ventilated children.
  • To evaluate the relationship between FiO₂ exposure and hospital stay duration.

Main Methods:

  • Prospective observational study in a tertiary PICU in India.
  • Enrolled children aged 1 month to 5 years requiring invasive ventilation >24 hours.
  • Calculated cumulative FiO₂ exposure and analyzed mortality and hospital stay duration.

Main Results:

  • Cumulative FiO₂ exposure independently predicted mortality (aOR: 1.22; p=0.027).
  • Higher FiO₂ exposure correlated strongly with longer hospital stays (Spearman r=0.74; p<0.001).
  • Male sex was also a mortality predictor (aOR: 2.38; p=0.046).

Conclusions:

  • Higher cumulative FiO₂ exposure is linked to increased mortality and hospital stay duration in critically ill children.
  • Findings underscore the need for rational oxygen titration and pediatric oxygen stewardship.
  • Reducing hyperoxia-related harm is crucial in pediatric intensive care.
Abstract

Keywords:
cumulative fio₂ exposurehyperoxialength of staymechanical ventilationmortalityoxygen toxicitypediatric intensive care

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