@article{e9c5dfb9e93f494e945a1307cb7634e3,
title = "Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: Insights from the LUNG SAFE study",
abstract = "Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073",
keywords = "Acute respiratory distress syndrome, Hyperoxemia, Hyperoxia, Hypoxemia, Hypoxia, Invasive mechanical ventilation, Mortality, Oxygen therapy",
author = "Fabiana Madotto and Emanuele Rezoagli and T{\`a}i Pham and Marcello Schmidt and Bairbre McNicholas and Alessandro Protti and Rakshit Panwar and Giacomo Bellani and Eddy Fan and {Van Haren}, Frank and Laurent Brochard and Laffey, {John G.} and {LUNG SAFE Investigators} and {ESICM Trials Group} and Antonio Pesenti and Andres Esteban and Luciano Gattinoni and Anders Larsson and McAuley, {Daniel F.} and Marco Ranieri and Gordon Rubenfeld and Thompson, {B. Taylor} and Hermann Wrigge and Slutsky, {Arthur S.} and Fernando Rios and T. Sottiaux and P. Depuydt and Lora, {Fredy S.} and Azevedo, {Luciano Cesar} and Guillermo Bugedo and Haibo Qiu and Marcos Gonzalez and Juan Silesky and Vladimir Cerny and Jonas Nielsen and Manuel Jibaja and Dimitrios Matamis and Ranero, {Jorge Luis} and Pravin Amin and Hashemian, {S. M.} and Kevin Clarkson and Kiyoyasu Kurahashi and Asisclo Villagomez and Zeggwagh, {Amine Ali} and Heunks, {Leo M.} and Laake, {Jon Henrik} and Palo, {Jose Emmanuel} and {Do Vale Fernandes}, Antero and Dorel Sandesc and Yaasen Arabi and Vesna Bumbasierevic and Nicolas Nin and Lorente, {Jose A.} and Lise Piquilloud and Fekri Abroug and Lia McNamee and Javier Hurtado and Ed Bajwa and Gabriel D{\'e}mpaire and Hektor Sula and Lordian Nunci and Alma Cani and Alan Zazu and Christian Dellera and Insaurralde, {Carolina S.} and Alejandro, {Risso V.} and Julio Daldin and Mauricio Vinzio and Fernandez, {Ruben O.} and Cardonnet, {Luis P.} and Bettini, {Lisandro R.} and Bisso, {Mariano Carboni} and Osman, {Emilio M.} and Setten, {Mariano G.} and Pablo Lovazzano and Javier Alvarez and Veronica Villar and Pozo, {Norberto C.} and Nicolas Grubissich and Plotnikow, {Gustavo A.} and Vasquez, {Daniela N.} and Santiago Ilutovich and Norberto Tiribelli and Ariel Chena and Pellegrini, {Carlos A.} and Saenz, {Mar{\'i}a G.} and Elisa Estenssoro and Matias Brizuela and Hernan Gianinetto and Gomez, {Pablo E.} and Cerrato, {Valeria I.} and Bezzi, {Marco G.} and Borello, {Silvina A.} and Loiacono, {Flavia A.} and Fernandez, {Adriana M.} and Serena Knowles and Claire Reynolds and Inskip, {Deborah M.} and Miller, {Jennene J.} and Jing Kong and Christina Whitehead and Shailesh Bihari and Aylin Seven and Amanda Krstevski and Rodgers, {Helen J.} and Millar, {Rebecca T.} and McKenna, {Toni E.} and Bailey, {Irene M.} and Hanlon, {Gabrielle C.} and Anders Aneman and Lynch, {Joan M.} and Raman Azad and John Neal and Woods, {Paul W.} and Roberts, {Brigit L.} and Kol, {Mark R.} and Wong, {Helen S.} and Riss, {Katharina C.} and Thomas Staudinger and Xavier Wittebole and Caroline Berghe and Bulpa, {Pierre A.} and Dive, {Alain M.} and Rik Verstraete and Herve Lebbinck and Joris Vermassen and Philippe Meersseman and Helga Ceunen and Rosa, {Jonas I.} and Beraldo, {Daniel O.} and Claudio Piras and Rampinelli, {Adenilton M.} and Nassar, {Antonio P.} and Sergio Mataloun and Marcelo Moock and Thompson, {Marlus M.} and Gon{\c c}alves, {Claudio H.} and Ant{\^o}nio, {Ana Carolina P.} and Aline Ascoli and Biondi, {Rodrigo S.} and Fontenele, {Danielle C.} and Danielle Nobrega and Sales, {Vanessa M.} and Suresh Shindhe and {Pg Hj Ismail}, {Dk Maizatul Aiman B.} and Francois Beloncle and Davies, {Kyle G.} and Rob Cirone and Venika Manoharan and Mehvish Ismail and Goligher, {Ewan C.} and Mandeep Jassal and Erin Nishikawa and Areej Javeed and Gerard Curley and Nuttapol Rittayamai and Matteo Parotto and Ferguson, {Niall D.} and Sangeeta Mehta and Jenny Knoll and Antoine Pronovost and Sergio Canestrini and Bruhn, {Alejandro R.} and Garcia, {Patricio H.} and Aliaga, {Felipe A.} and Far{\'i}as, {Pamela A.} and Yumha, {Jacob S.} and Ortiz, {Claudia A.} and Salas, {Javier E.} and Saez, {Alejandro A.} and Vega, {Luis D.} and Labarca, {Eduardo F.} and Martinez, {Felipe T.} and Carre{\~n}o, {Nicol{\'a}s G.} and Pilar Lora and Haitao Liu and Ling Liu and Rui Tang and Xiaoming Luo and Youzhong An and Huiying Zhao and Yan Gao and Zhe Zhai and Ye, {Zheng L.} and Wei Wang and Wenwen Li and Qingdong Li and Ruiqiang Zheng and Wenkui Yu and Juanhong Shen and Xinyu Li and Tao Yu and Weihua Lu and Wu, {Ya Q.} and Huang, {Xiao B.} and Zhenyang He and Yuanhua Lu and Hui Han and Fan Zhang and Renhua Sun and Wang, {Hua X.} and Qin, {Shu H.} and Zhu, {Bao H.} and Jun Zhao and Jian Liu and Bin Li and Liu, {Jing L.} and Zhou, {Fa C.} and Li, {Qiong J.} and Zhang, {Xing Y.} and Zhou Li-Xin and Qiang Xin-Hua and Liangyan Jiang and Gao, {Yuan N.} and Zhao, {Xian Y.} and Li, {Yuan Y.} and Li, {Xiao L.} and Chunting Wang and Qingchun Yao and Rongguo Yu and Kai Chen and Huanzhang Shao and Bingyu Qin and Huang, {Qing Q.} and Zhu, {Wei H.} and Hang, {Ai Y.} and Hua, {Ma X.} and Yimin Li and Yonghao Xu and Di, {Yu D.} and Ling, {Long L.} and Qin, {Tie H.} and Wang, {Shou H.} and Junping Qin and Yi Han and Suming Zhou and Vargas, {Monica P.} and {Silesky Jimenez}, {Juan I.} and {Gonz{\'a}lez Rojas}, {Manuel A.} and Solis-Quesada, {Jaime E.} and Ramirez-Alfaro, {Christian M.} and Jan M{\'a}ca",
note = "This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.",
year = "2020",
month = mar,
day = "31",
doi = "10.1186/s13054-020-2826-6",
language = "English",
volume = "24",
journal = "Critical Care",
issn = "1364-8535",
publisher = "BioMed Central Ltd.",
number = "1",
}