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Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study
- Source :
- Resuscitation. 101:108-114
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- In mechanically ventilated (MV) cardiac arrest (CA) survivors admitted to the intensive care unit (ICU) avoidance of hypoxia is considered crucial. However, avoidance of hyperoxia may also be important. A conservative approach to oxygen therapy may reduce exposure to both.We evaluated the introduction of conservative oxygen therapy (target SpO2 88-92% using the lowest FiO2) during MV for resuscitated CA patients admitted to the ICU.We studied 912 arterial blood gas (ABG) datasets: 448 ABGs from 50 'conventional' and 464 ABGs from 50 'conservative' oxygen therapy patients. Compared to the conventional group, conservative group patients had significantly lower PaO2 values and FiO2 exposure (p0.001, respectively); more received MV in a spontaneous ventilation mode (18% vs 2%; p=0.001) and more were exposed to a FiO2 of 0.21 (19 vs 0 patients, p=0.001). Additionally, according to mean PaO2, more conservative group patients were classified as normoxaemic (36 vs 16 patients, p0.01) and fewer as hyperoxaemic (14 vs 33 patients, p0.01). Finally, ICU length of stay was significantly shorter for conservative group patients (p=0.04). There was no difference in the proportion of survivors discharged from hospital with good neurological outcome (14/23 vs 12/22 patients, p=0.67).Our findings provide preliminary support for the feasibility and physiological safety of conservative oxygen therapy in patients admitted to ICU for MV support after cardiac arrest (Trial registration, NCT01684124).
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
030204 cardiovascular system & hematology
Emergency Nursing
Conservative Treatment
law.invention
Cohort Studies
03 medical and health sciences
0302 clinical medicine
law
Intensive care
Oxygen therapy
medicine
Humans
Aged
Retrospective Studies
Hyperoxia
Mechanical ventilation
business.industry
Oxygen Inhalation Therapy
030208 emergency & critical care medicine
Middle Aged
Hypoxia (medical)
Respiration, Artificial
Intensive care unit
Heart Arrest
Surgery
Anesthesia
Emergency Medicine
Arterial blood
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Cohort study
Subjects
Details
- ISSN :
- 03009572 and 01684124
- Volume :
- 101
- Database :
- OpenAIRE
- Journal :
- Resuscitation
- Accession number :
- edsair.doi.dedup.....732b5bbdd64c098bd9a1214208b5f7fd