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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Conservative versus liberal oxygenation targets for mechanically ventilated patients: pilot multicentre randomised trial</title><author><name sortKey="Barrot, L" sort="Barrot, L" uniqKey="Barrot L" first="L" last="Barrot">L. Barrot</name><affiliation><nlm:aff id="Aff1">CHRU Besançon, Medical ICU, Besancon, France</nlm:aff></affiliation></author><author><name sortKey="Panwar, R" sort="Panwar, R" uniqKey="Panwar R" first="R" last="Panwar">R. Panwar</name><affiliation><nlm:aff id="Aff2">John Hunter Hospital, Newcastle, Australia</nlm:aff></affiliation></author><author><name sortKey="Hardie, M" sort="Hardie, M" uniqKey="Hardie M" first="M" last="Hardie">M. Hardie</name><affiliation><nlm:aff id="Aff3">John Hunter Hospital, ICU, Newcastle, Australia</nlm:aff></affiliation></author><author><name sortKey="Bellomo, R" sort="Bellomo, R" uniqKey="Bellomo R" first="R" last="Bellomo">R. Bellomo</name><affiliation><nlm:aff id="Aff4">Department of Intensive Care, Austin Hospital, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Eastwood, G" sort="Eastwood, G" uniqKey="Eastwood G" first="G" last="Eastwood">G. Eastwood</name><affiliation><nlm:aff id="Aff5">Austin Hospital, Intensive Care Unit, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Young, P" sort="Young, P" uniqKey="Young P" first="P" last="Young">P. Young</name><affiliation><nlm:aff id="Aff6">Wellington Hospital, Wellington, and Medical Research Institute of New Zealand, Intensive Care Unit, Wellington, New Zealand</nlm:aff></affiliation></author><author><name sortKey="Harrigan, P" sort="Harrigan, P" uniqKey="Harrigan P" first="P" last="Harrigan">P. Harrigan</name><affiliation><nlm:aff id="Aff7">John Hunter Hospital, Intensive Care Unit, Newcastle, Australia</nlm:aff></affiliation></author><author><name sortKey="Bailey, M" sort="Bailey, M" uniqKey="Bailey M" first="M" last="Bailey">M. Bailey</name><affiliation><nlm:aff id="Aff8">Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Capellier, G" sort="Capellier, G" uniqKey="Capellier G" first="G" last="Capellier">G. Capellier</name><affiliation><nlm:aff id="Aff9">CHRU Besançon, Intensive Care Unit, Besançon, France</nlm:aff></affiliation><affiliation><nlm:aff id="Aff10">Franche-Comté University, EA 3920 Besançon, France</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">4798309</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4798309</idno><idno type="RBID">PMC:4798309</idno><idno type="doi">10.1186/2197-425X-3-S1-A423</idno><idno type="pmid">NONE</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000916</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000916</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Conservative versus liberal oxygenation targets for mechanically ventilated patients: pilot multicentre randomised trial</title><author><name sortKey="Barrot, L" sort="Barrot, L" uniqKey="Barrot L" first="L" last="Barrot">L. Barrot</name><affiliation><nlm:aff id="Aff1">CHRU Besançon, Medical ICU, Besancon, France</nlm:aff></affiliation></author><author><name sortKey="Panwar, R" sort="Panwar, R" uniqKey="Panwar R" first="R" last="Panwar">R. Panwar</name><affiliation><nlm:aff id="Aff2">John Hunter Hospital, Newcastle, Australia</nlm:aff></affiliation></author><author><name sortKey="Hardie, M" sort="Hardie, M" uniqKey="Hardie M" first="M" last="Hardie">M. Hardie</name><affiliation><nlm:aff id="Aff3">John Hunter Hospital, ICU, Newcastle, Australia</nlm:aff></affiliation></author><author><name sortKey="Bellomo, R" sort="Bellomo, R" uniqKey="Bellomo R" first="R" last="Bellomo">R. Bellomo</name><affiliation><nlm:aff id="Aff4">Department of Intensive Care, Austin Hospital, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Eastwood, G" sort="Eastwood, G" uniqKey="Eastwood G" first="G" last="Eastwood">G. Eastwood</name><affiliation><nlm:aff id="Aff5">Austin Hospital, Intensive Care Unit, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Young, P" sort="Young, P" uniqKey="Young P" first="P" last="Young">P. Young</name><affiliation><nlm:aff id="Aff6">Wellington Hospital, Wellington, and Medical Research Institute of New Zealand, Intensive Care Unit, Wellington, New Zealand</nlm:aff></affiliation></author><author><name sortKey="Harrigan, P" sort="Harrigan, P" uniqKey="Harrigan P" first="P" last="Harrigan">P. Harrigan</name><affiliation><nlm:aff id="Aff7">John Hunter Hospital, Intensive Care Unit, Newcastle, Australia</nlm:aff></affiliation></author><author><name sortKey="Bailey, M" sort="Bailey, M" uniqKey="Bailey M" first="M" last="Bailey">M. Bailey</name><affiliation><nlm:aff id="Aff8">Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Capellier, G" sort="Capellier, G" uniqKey="Capellier G" first="G" last="Capellier">G. Capellier</name><affiliation><nlm:aff id="Aff9">CHRU Besançon, Intensive Care Unit, Besançon, France</nlm:aff></affiliation><affiliation><nlm:aff id="Aff10">Franche-Comté University, EA 3920 Besançon, France</nlm:aff></affiliation></author></analytic><series><title level="j">Intensive Care Medicine Experimental</title><idno type="eISSN">2197-425X</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Damiani, E" uniqKey="Damiani E">E Damiani</name></author><author><name sortKey="Adrario, E" uniqKey="Adrario E">E Adrario</name></author><author><name sortKey="Girardis, M" uniqKey="Girardis M">M Girardis</name></author><author><name sortKey="Romano, R" uniqKey="Romano R">R Romano</name></author><author><name sortKey="Pelaia, P" uniqKey="Pelaia P">P Pelaia</name></author><author><name sortKey="Singer, M" uniqKey="Singer M">M Singer</name></author><author><name sortKey="Donati, A" uniqKey="Donati A">A Donati</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Panwar, R" uniqKey="Panwar R">R Panwar</name></author><author><name sortKey="Capellier, G" uniqKey="Capellier G">G Capellier</name></author><author><name sortKey="Schmutz, N" uniqKey="Schmutz N">N Schmutz</name></author><author><name sortKey="Davies, A" uniqKey="Davies A">A Davies</name></author><author><name sortKey="Cooper, Dj" uniqKey="Cooper D">DJ Cooper</name></author><author><name sortKey="Bailey, M" uniqKey="Bailey M">M Bailey</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="abstract"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Intensive Care Med Exp</journal-id><journal-id journal-id-type="iso-abbrev">Intensive Care Med Exp</journal-id><journal-title-group><journal-title>Intensive Care Medicine Experimental</journal-title></journal-title-group><issn pub-type="epub">2197-425X</issn><publisher><publisher-name>Springer International Publishing</publisher-name><publisher-loc>Cham</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">4798309</article-id><article-id pub-id-type="publisher-id">567</article-id><article-id pub-id-type="doi">10.1186/2197-425X-3-S1-A423</article-id><article-categories><subj-group subj-group-type="heading"><subject>Poster Presentation</subject></subj-group></article-categories><title-group><article-title>Conservative versus liberal oxygenation targets for mechanically ventilated patients: pilot multicentre randomised trial</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Barrot</surname><given-names>L</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Panwar</surname><given-names>R</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Hardie</surname><given-names>M</given-names></name><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Bellomo</surname><given-names>R</given-names></name><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Eastwood</surname><given-names>G</given-names></name><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Young</surname><given-names>P</given-names></name><xref ref-type="aff" rid="Aff6"></xref></contrib><contrib contrib-type="author"><name><surname>Harrigan</surname><given-names>P</given-names></name><xref ref-type="aff" rid="Aff7"></xref></contrib><contrib contrib-type="author"><name><surname>Bailey</surname><given-names>M</given-names></name><xref ref-type="aff" rid="Aff8"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Capellier</surname><given-names>G</given-names></name><xref ref-type="aff" rid="Aff9"></xref><xref ref-type="aff" rid="Aff10"></xref></contrib><contrib contrib-type="author"><collab>CLOSE Study Investigators and the ANZICS Clinical Trials Group</collab></contrib><aff id="Aff1"><label></label>CHRU Besançon, Medical ICU, Besancon, France</aff><aff id="Aff2"><label></label>John Hunter Hospital, Newcastle, Australia</aff><aff id="Aff3"><label></label>John Hunter Hospital, ICU, Newcastle, Australia</aff><aff id="Aff4"><label></label>Department of Intensive Care, Austin Hospital, Melbourne, Australia</aff><aff id="Aff5"><label></label>Austin Hospital, Intensive Care Unit, Melbourne, Australia</aff><aff id="Aff6"><label></label>Wellington Hospital, Wellington, and Medical Research Institute of New Zealand, Intensive Care Unit, Wellington, New Zealand</aff><aff id="Aff7"><label></label>John Hunter Hospital, Intensive Care Unit, Newcastle, Australia</aff><aff id="Aff8"><label></label>Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Melbourne, Australia</aff><aff id="Aff9"><label></label>CHRU Besançon, Intensive Care Unit, Besançon, France</aff><aff id="Aff10"><label></label>Franche-Comté University, EA 3920 Besançon, France</aff></contrib-group><pub-date pub-type="epub"><day>1</day><month>10</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>10</month><year>2015</year></pub-date><pub-date pub-type="collection"><month>12</month><year>2015</year></pub-date><volume>3</volume><issue>Suppl 1</issue><issue-sponsor>The publication charges for this supplement were funded by Intensive Care Medicine Experimental.</issue-sponsor><elocation-id>A423</elocation-id><permissions><copyright-statement>© Barrot et al.; 2015</copyright-statement><license license-type="open-access"><license-p>This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><conference><conf-name>ESICM LIVES 2015</conf-name><conf-loc>Berlin, Germany</conf-loc><conf-date>3-7 October 2015</conf-date><string-conf><uri>http://www.esicm.org/</uri></string-conf></conference><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2015</meta-value></custom-meta></custom-meta-group></article-meta></front><body><sec id="Sec1"><title>Introduction</title><p>There is now increasing recognition of potential harm due to hyperoxia. Conventional practice of oxygen therapy often result in hyperoxia. Nearly all patients on mechanical ventilation receive supplemental oxygen therapy. However, RCTs investigating the effects of different oxygenation level during MV are lacking</p></sec><sec id="Sec2"><title>Objectives</title><p>We aim to systematically evaluate whether liberal oxygenation strategy is beneficial or harmful compared to conservative oxygenation strategy for patients on invasive MV.</p></sec><sec id="Sec3"><title>Methods</title><p>Patients likely to require 48 hours of MV, older than 18 years were included. Prospective trial conducted in 4 university affiliated ICU in Australia, New Zealand and France. Enrolled patients were randomly allocated to either liberal or conservative oxygenation arm(SaO2/SpO2 >96% or between 88-92% respectively) and followed until day 90. The bedside nurse titrated FiO2 to reach the oxygenation target.</p></sec><sec id="Sec4"><title>Results</title><p>357 patients were screened and 104 were enrolled, 53 and 51 respectively in conservative and liberal arm respectively. Patients characteristics were similar at baseline. ABG’s were checked more often in the conservative arm. Using an hypoxemia threshold of SpO2 < 88%, 1% and 0.3% of the values in the conservative and liberal arm respectively were in hypoxemic range. With a PaO2 threshold < 55 mmHg, 7% and 1% respectively of the values were in hypoxemic range. With a threshold of SpO2>98% while FiO2 > 0.21, 4% and 22% of SpO2 values respectively were in the hyperoxic range. Same difference were found when using an hyperoxic threshold of PaO2>120 mmHg (p < 0.05 for all comparison). Participants spent majority of time within the intended target range in both groups. Mean AUC and 95%CI for SpO2, SaO2, PaO2 and FiO2 were significantly lower in the conservative group compared to liberal group. Survival analysis curve were similar for both groups (OR 0.77 (95%CI:0.4-1.50; p = 0.44)). For patients with a P/F ratio < 300, the separation in mean FiO2 was wider between the two arms. Outcome were similar. There slightly more arrhythmia-free days in the conservative arm. In thisP/F < 300 subgroup, the adjusted hazard ratio for death by day 90 was lower in the conservative arm compared to liberal arm.</p></sec><sec id="Sec5"><title>Conclusions</title><p>Our study demonstrate that conservative oxygenation strategy is a feasible and safe alternative to the usual liberal oxygenation strategy.</p></sec><sec id="Sec6"><title>Grant Acknowledgment</title><p>Intensive Care Foundation (ANZ), University Hospital Besançon (France) and Don Du Souffle (France).</p></sec></body><back><ref-list id="Bib1"><title>References</title><ref id="CR1"><label>1.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Damiani</surname><given-names>E</given-names></name><name><surname>Adrario</surname><given-names>E</given-names></name><name><surname>Girardis</surname><given-names>M</given-names></name><name><surname>Romano</surname><given-names>R</given-names></name><name><surname>Pelaia</surname><given-names>P</given-names></name><name><surname>Singer</surname><given-names>M</given-names></name><name><surname>Donati</surname><given-names>A</given-names></name></person-group><article-title>Arterial hyperoxia and mortality in critically ill patients: a systematic review and meta-analysis</article-title><source>Crit Care</source><year>2014</year><volume>18</volume><issue>6</issue><fpage>711</fpage><pub-id pub-id-type="doi">10.1186/s13054-014-0711-x</pub-id><pub-id pub-id-type="pmid">25532567</pub-id></element-citation></ref><ref id="CR2"><label>2.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Panwar</surname><given-names>R</given-names></name><name><surname>Capellier</surname><given-names>G</given-names></name><name><surname>Schmutz</surname><given-names>N</given-names></name><name><surname>Davies</surname><given-names>A</given-names></name><name><surname>Cooper</surname><given-names>DJ</given-names></name><name><surname>Bailey</surname><given-names>M</given-names></name><etal></etal></person-group><article-title>Current oxygenation practice in ventilated patients-an observational cohort study</article-title><source>Anaesth Intensive Care</source><year>2013</year><volume>41</volume><issue>4</issue><fpage>505</fpage><lpage>514</lpage><pub-id pub-id-type="pmid">23808511</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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