Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure
Olav Lilleholt Schjørring, Thomas Klitgaard, Anders Perner, Jørn Wetterslev, Theis Lange, Martin Siegemund, Minna Bäcklund, Frederik Keus, Jon Henrik Laake, Matt Morgan, Katrín Þormar, Søren A Rosborg, Jannie Bisgaard, Annette E S Erntgaard, Anne-Sofie H Lynnerup, Rasmus L Pedersen, Elena Crescioli, Theis C Gielstrup, Meike T. Behzadi, Lone Musaeus Poulsen, Stine Estrup, Jens Laigaard, Cheme Andersen, Camilla Bekker Mortensen, Björn Brand, Jonathan White, Inge-Lise Jarnvig, Morten Hylander Møller, Lars Quist, Morten H. Bestle, Martin Schønemann‐Lund, Maj K. Kamper, Mathias Hindborg, Alexa Hollinger, Caroline E. Gebhard, Núria Zellweger, Christian S. Meyhoff, Mathias Hjort, Laura K. Bech, Thorbjørn Grøfte, Helle Bundgaard, Lars Henrik Østergaard, Maria A Thyø, Thomas Hildebrandt, Bülent Uslu, Christoffer Sølling, Nette Møller-Nielsen, Anne Craveiro Brøchner, Morten Borup, Marjatta Okkonen, Willem Dieperink, U. G. Pedersen, Anne Sofie Andreasen, Lone Buus, Tayyba Naz Aslam, Robert Winding, Joerg C. Schefold, Stine Borch Thorup, Susanne Iversen, Janus Engstrøm, Maj-Brit N Kjær, Bodil Steen Rasmussen
Abstract
BACKGROUND: ) would result in lower mortality than using a higher target. METHODS: of either 60 mm Hg (lower-oxygenation group) or 90 mm Hg (higher-oxygenation group) for a maximum of 90 days. The primary outcome was death within 90 days. RESULTS: At 90 days, 618 of 1441 patients (42.9%) in the lower-oxygenation group and 613 of 1447 patients (42.4%) in the higher-oxygenation group had died (adjusted risk ratio, 1.02; 95% confidence interval, 0.94 to 1.11; P = 0.64). At 90 days, there was no significant between-group difference in the percentage of days that patients were alive without life support or in the percentage of days they were alive after hospital discharge. The percentages of patients who had new episodes of shock, myocardial ischemia, ischemic stroke, or intestinal ischemia were similar in the two groups (P = 0.24). CONCLUSIONS: Among adult patients with acute hypoxemic respiratory failure in the ICU, a lower oxygenation target did not result in lower mortality than a higher target at 90 days. (Funded by the Innovation Fund Denmark and others; HOT-ICU ClinicalTrials.gov number, NCT03174002.).