Skip Navigation LinksHome > June 2014 - Volume 42 - Issue 6 > Conservative Oxygen Therapy in Mechanically Ventilated Patie...
Critical Care Medicine:
doi: 10.1097/CCM.0000000000000219
Clinical Investigations

Conservative Oxygen Therapy in Mechanically Ventilated Patients: A Pilot Before-and-After Trial*

Suzuki, Satoshi MD, PhD1; Eastwood, Glenn M. PhD1; Glassford, Neil J. MD, MRCP1; Peck, Leah RN1; Young, Helen RN1; Garcia-Alvarez, Mercedes MD1; Schneider, Antoine G. MD1; Bellomo, Rinaldo MD, FCICM1,2

Supplemental Author Material
Collapse Box

Abstract

Objectives:

To assess the feasibility and safety of a conservative approach to oxygen therapy in mechanically ventilated ICU patients.

Design:

Pilot prospective before-and-after study.

Setting:

A 22-bed multidisciplinary ICU of a tertiary care hospital in Australia.

Patients:

A total of 105 adult (18 years old or older) patients required mechanical ventilation for more than 48 hours: 51 patients during the “conventional” before period and 54 after a change to “conservative” oxygen therapy.

Interventions:

Implementation of a conservative approach to oxygen therapy (target Spo2 of 90–92%).

Measurements and Main Results:

We collected 3,169 datasets on 799 mechanical ventilation days. During conservative oxygen therapy the median time-weighted average Spo2 on mechanical ventilation was 95.5% (interquartile range, 94.0–97.3) versus 98.4% (97.3–99.1) (p < 0.001) during conventional therapy. The median Pao2 was 83 torr (71–94) versus 107 torr (94–131) (p < 0.001) with a change to a median Fio2 of 0.27 (0.24–0.30) versus 0.40 (0.35–0.44) (p < 0.001). Conservative oxygen therapy decreased the median total amount of oxygen delivered during mechanical ventilation by about two thirds (15,580 L [8,263–29,351 L] vs 5,122 L [1,837–10,499 L]; p < 0.001). The evolution of the Pao2/Fio2 ratio was similar during the two periods, and there were no difference in any other biochemical or clinical outcomes.

Conclusions:

Conservative oxygen therapy in mechanically ventilated ICU patients was feasible and free of adverse biochemical, physiological, or clinical outcomes while allowing a marked decrease in excess oxygen exposure. Our study supports the safety and feasibility of future pilot randomized controlled trials of conventional compared with conservative oxygen therapy.

Copyright © 2014 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

Article Tools

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.