Is too much oxygen detrimental to critical patients? This study published in JAMA looked at whether it was better to maintain patients oxygen saturation at 94-98%(conservative oxygen therapy) versus 97-100%(conventional oxygen therapy). Mortality was found to be significantly higher in the conventional oxygen therapy group as was the relative risk of new shock episode,liver failure and new bloodstream infection. The study was concluded early because of the dramatic results and the authors call for a large multi-center study to confirm the results.
Key Points Question Among critically ill patients, is a conservative oxygenation strategy aimed to maintain arterial saturation within physiologic limits more beneficial than a conventional strategy? Findings In this randomized clinical trial that included 480 patients with an expected intensive care unit length of stay of 72 hours or longer, a conservative protocol for oxygen supplementation was associated with an absolute risk reduction for intensive care unit mortality of 8.6% compared with that for patients treated with conventional therapy. However, the trial was terminated early because of difficulty with patient enrollment. Meaning Among critically ill intensive care unit patients with a length of stay of 72 hours or longer, a conservative protocol for oxygen therapy may be beneficial; however, because the trial was terminated early, these findings must be considered preliminary.
