在重症监护病人的保守与自由氧化目标 (ICONIC):一个随机临床试验
L Imeen van der Wal1,2, Chloe C A Grim1,2, Michael R Del Prado1
1Department of Intensive Care.
American journal of respiratory and critical care medicine
|August 8, 2023
概括
与高氧化相比,低氧化策略没有降低ICU患者的28天死亡率. 这项关于机械通风的研究发现,两种氧气目标之间的生存率没有显著差异.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 临床试验 临床试验
背景情况:
- 补充氧气是ICU患者的标准,但最佳氧化目标仍在争论中.
- 关于将死亡率降至最低的理想氧和水平存在不确定性.
研究的目的:
- 为了比较机械通风ICU患者的低氧化和高氧化策略之间的28天死亡率.
- 为了确定保守的氧气方法是否能改善生存结果.
主要方法:
- 一个随机的多中心试验,涉及机械通风ICU患者.
- 患者被分配到低氧化 (PaO2: 55-80 mmHg; SpO2: 91-94%) 或高氧化 (PaO2: 110-150 mmHg; SpO2: 96-100%) 的目标.
- 主要终点是28天死亡率;由于COVID-19大流行,该研究被提前停止.
主要成果:
- 包括664名患者 (335名低氧化,329名高氧化).
- 低氧化组的28天死亡率为38.5%,高氧化组为34.7% (风险比:1.11;P=0.30).
- 两组之间没有观察到严重不良事件的显著差异.
结论:
- 在这种患者群体中,低氧化策略与高氧化策略相比,没有降低28天死亡率.
- 这些发现表明,目前的高氧化目标可能是可以接受的,但需要进一步的研究.
- 试验过早停止,限制了最终的结论.
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