Conservative versus Liberal Oxygenation Targets for Mechanically Ventilated Patients. A Pilot Multicenter Randomized Controlled Trial.
Identifieur interne : 002430 ( PubMed/Corpus ); précédent : 002429; suivant : 002431Conservative versus Liberal Oxygenation Targets for Mechanically Ventilated Patients. A Pilot Multicenter Randomized Controlled Trial.
Auteurs : Rakshit Panwar ; Miranda Hardie ; Rinaldo Bellomo ; Loïc Barrot ; Glenn M. Eastwood ; Paul J. Young ; Gilles Capellier ; Peter W J. Harrigan ; Michael BaileySource :
- American journal of respiratory and critical care medicine [ 1535-4970 ] ; 2016.
English descriptors
- KwdEn :
- MESH :
- chemical , blood : Oxygen.
- methods : Oxygen Inhalation Therapy, Respiration, Artificial.
- Female, Humans, Intensive Care Units, Male, Middle Aged, Oximetry, Pilot Projects.
Abstract
There are no randomized controlled trials comparing different oxygenation targets for intensive care unit (ICU) patients.
DOI: 10.1164/rccm.201505-1019OC
PubMed: 26334785
Links to Exploration step
pubmed:26334785Le document en format XML
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A Pilot Multicenter Randomized Controlled Trial.</title><author><name sortKey="Panwar, Rakshit" sort="Panwar, Rakshit" uniqKey="Panwar R" first="Rakshit" last="Panwar">Rakshit Panwar</name><affiliation><nlm:affiliation>1 Intensive Care Unit, John Hunter Hospital, Newcastle, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hardie, Miranda" sort="Hardie, Miranda" uniqKey="Hardie M" first="Miranda" last="Hardie">Miranda Hardie</name><affiliation><nlm:affiliation>1 Intensive Care Unit, John Hunter Hospital, Newcastle, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Bellomo, Rinaldo" sort="Bellomo, Rinaldo" uniqKey="Bellomo R" first="Rinaldo" last="Bellomo">Rinaldo Bellomo</name><affiliation><nlm:affiliation>3 Department of Intensive Care, Austin Hospital, The University of Melbourne, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Barrot, Loic" sort="Barrot, Loic" uniqKey="Barrot L" first="Loïc" last="Barrot">Loïc Barrot</name><affiliation><nlm:affiliation>5 Critical Care Unit, University Hospital Besançon and University of Franche-Comté, Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Eastwood, Glenn M" sort="Eastwood, Glenn M" uniqKey="Eastwood G" first="Glenn M" last="Eastwood">Glenn M. Eastwood</name><affiliation><nlm:affiliation>3 Department of Intensive Care, Austin Hospital, The University of Melbourne, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Young, Paul J" sort="Young, Paul J" uniqKey="Young P" first="Paul J" last="Young">Paul J. Young</name><affiliation><nlm:affiliation>6 Intensive Care Unit, Wellington Hospital, Wellington, New Zealand; and.</nlm:affiliation></affiliation></author><author><name sortKey="Capellier, Gilles" sort="Capellier, Gilles" uniqKey="Capellier G" first="Gilles" last="Capellier">Gilles Capellier</name><affiliation><nlm:affiliation>4 Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Harrigan, Peter W J" sort="Harrigan, Peter W J" uniqKey="Harrigan P" first="Peter W J" last="Harrigan">Peter W J. Harrigan</name><affiliation><nlm:affiliation>1 Intensive Care Unit, John Hunter Hospital, Newcastle, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Bailey, Michael" sort="Bailey, Michael" uniqKey="Bailey M" first="Michael" last="Bailey">Michael Bailey</name><affiliation><nlm:affiliation>4 Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26334785</idno><idno type="pmid">26334785</idno><idno type="doi">10.1164/rccm.201505-1019OC</idno><idno type="wicri:Area/PubMed/Corpus">002430</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002430</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Conservative versus Liberal Oxygenation Targets for Mechanically Ventilated Patients. A Pilot Multicenter Randomized Controlled Trial.</title><author><name sortKey="Panwar, Rakshit" sort="Panwar, Rakshit" uniqKey="Panwar R" first="Rakshit" last="Panwar">Rakshit Panwar</name><affiliation><nlm:affiliation>1 Intensive Care Unit, John Hunter Hospital, Newcastle, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hardie, Miranda" sort="Hardie, Miranda" uniqKey="Hardie M" first="Miranda" last="Hardie">Miranda Hardie</name><affiliation><nlm:affiliation>1 Intensive Care Unit, John Hunter Hospital, Newcastle, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Bellomo, Rinaldo" sort="Bellomo, Rinaldo" uniqKey="Bellomo R" first="Rinaldo" last="Bellomo">Rinaldo Bellomo</name><affiliation><nlm:affiliation>3 Department of Intensive Care, Austin Hospital, The University of Melbourne, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Barrot, Loic" sort="Barrot, Loic" uniqKey="Barrot L" first="Loïc" last="Barrot">Loïc Barrot</name><affiliation><nlm:affiliation>5 Critical Care Unit, University Hospital Besançon and University of Franche-Comté, Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Eastwood, Glenn M" sort="Eastwood, Glenn M" uniqKey="Eastwood G" first="Glenn M" last="Eastwood">Glenn M. Eastwood</name><affiliation><nlm:affiliation>3 Department of Intensive Care, Austin Hospital, The University of Melbourne, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Young, Paul J" sort="Young, Paul J" uniqKey="Young P" first="Paul J" last="Young">Paul J. Young</name><affiliation><nlm:affiliation>6 Intensive Care Unit, Wellington Hospital, Wellington, New Zealand; and.</nlm:affiliation></affiliation></author><author><name sortKey="Capellier, Gilles" sort="Capellier, Gilles" uniqKey="Capellier G" first="Gilles" last="Capellier">Gilles Capellier</name><affiliation><nlm:affiliation>4 Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Harrigan, Peter W J" sort="Harrigan, Peter W J" uniqKey="Harrigan P" first="Peter W J" last="Harrigan">Peter W J. Harrigan</name><affiliation><nlm:affiliation>1 Intensive Care Unit, John Hunter Hospital, Newcastle, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Bailey, Michael" sort="Bailey, Michael" uniqKey="Bailey M" first="Michael" last="Bailey">Michael Bailey</name><affiliation><nlm:affiliation>4 Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</nlm:affiliation></affiliation></author></analytic><series><title level="j">American journal of respiratory and critical care medicine</title><idno type="eISSN">1535-4970</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Female</term><term>Humans</term><term>Intensive Care Units</term><term>Male</term><term>Middle Aged</term><term>Oximetry</term><term>Oxygen (blood)</term><term>Oxygen Inhalation Therapy (methods)</term><term>Pilot Projects</term><term>Respiration, Artificial (methods)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Oxygen</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Oxygen Inhalation Therapy</term><term>Respiration, Artificial</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Humans</term><term>Intensive Care Units</term><term>Male</term><term>Middle Aged</term><term>Oximetry</term><term>Pilot Projects</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">There are no randomized controlled trials comparing different oxygenation targets for intensive care unit (ICU) patients.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26334785</PMID><DateCreated><Year>2016</Year><Month>01</Month><Day>01</Day></DateCreated><DateCompleted><Year>2016</Year><Month>05</Month><Day>04</Day></DateCompleted><DateRevised><Year>2016</Year><Month>01</Month><Day>01</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1535-4970</ISSN><JournalIssue CitedMedium="Internet"><Volume>193</Volume><Issue>1</Issue><PubDate><Year>2016</Year><Month>Jan</Month><Day>01</Day></PubDate></JournalIssue><Title>American journal of respiratory and critical care medicine</Title><ISOAbbreviation>Am. J. Respir. Crit. Care Med.</ISOAbbreviation></Journal><ArticleTitle>Conservative versus Liberal Oxygenation Targets for Mechanically Ventilated Patients. A Pilot Multicenter Randomized Controlled Trial.</ArticleTitle><Pagination><MedlinePgn>43-51</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1164/rccm.201505-1019OC</ELocationID><Abstract><AbstractText Label="RATIONALE" NlmCategory="BACKGROUND">There are no randomized controlled trials comparing different oxygenation targets for intensive care unit (ICU) patients.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To determine whether a conservative oxygenation strategy is a feasible alternative to a liberal oxygenation strategy among ICU patients requiring invasive mechanical ventilation (IMV).</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">At four multidisciplinary ICUs, 103 adult patients deemed likely to require IMV for greater than or equal to 24 hours were randomly allocated to either a conservative oxygenation strategy with target oxygen saturation as measured by pulse oximetry (SpO2) of 88-92% (n = 52) or a liberal oxygenation strategy with target SpO2 of greater than or equal to 96% (n = 51).</AbstractText><AbstractText Label="MEASUREMENTS AND MAIN RESULTS" NlmCategory="RESULTS">The mean area under the curve and 95% confidence interval (CI) for SpO2 (93.4% [92.9-93.9%] vs. 97% [96.5-97.5%]), SaO2 (93.5% [93.1-94%] vs. 96.8% [96.3-97.3%]), PaO2 (70 [68-73] mm Hg vs. 92 [89-96] mm Hg), and FiO2 (0.26 [0.25-0.28] vs. 0.36 [0.34-0.39) in the conservative versus liberal oxygenation arm were significantly different (P < 0.0001 for all). There were no significant between-group differences in any measures of new organ dysfunction, or ICU or 90-day mortality. The percentage time spent with SpO2 less than 88% in conservative versus liberal arm was 1% versus 0.3% (P = 0.03), and percentage time spent with SpO2 greater than 98% in conservative versus liberal arm was 4% versus 22% (P < 0.001). The adjusted hazard ratio for 90-day mortality in the conservative arm was 0.77 (95% CI, 0.40-1.50; P = 0.44) overall and 0.49 (95% CI, 0.20-1.17; P = 0.10) in the prespecified subgroup of patients with a baseline PaO2/FiO2 less than 300.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Our study supports the feasibility of a conservative oxygenation strategy in patients receiving IMV. Larger randomized controlled trials of this intervention appear justified. Clinical trial registered with Australian New Zealand Clinical Trials Registry (ACTRN 12613000505707).</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Panwar</LastName><ForeName>Rakshit</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>1 Intensive Care Unit, John Hunter Hospital, Newcastle, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2 School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hardie</LastName><ForeName>Miranda</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>1 Intensive Care Unit, John Hunter Hospital, Newcastle, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bellomo</LastName><ForeName>Rinaldo</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>3 Department of Intensive Care, Austin Hospital, The University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>4 Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barrot</LastName><ForeName>Loïc</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>5 Critical Care Unit, University Hospital Besançon and University of Franche-Comté, Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eastwood</LastName><ForeName>Glenn M</ForeName><Initials>GM</Initials><AffiliationInfo><Affiliation>3 Department of Intensive Care, Austin Hospital, The University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>4 Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Young</LastName><ForeName>Paul J</ForeName><Initials>PJ</Initials><AffiliationInfo><Affiliation>6 Intensive Care Unit, Wellington Hospital, Wellington, New Zealand; and.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>7 Medical Research Institute of New Zealand, Wellington, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Capellier</LastName><ForeName>Gilles</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>4 Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>5 Critical Care Unit, University Hospital Besançon and University of Franche-Comté, Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Harrigan</LastName><ForeName>Peter W J</ForeName><Initials>PW</Initials><AffiliationInfo><Affiliation>1 Intensive Care Unit, John Hunter Hospital, Newcastle, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2 School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bailey</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>4 Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>CLOSE Study Investigators</CollectiveName></Author><Author ValidYN="Y"><CollectiveName>ANZICS Clinical Trials Group</CollectiveName></Author></AuthorList><Language>eng</Language><DataBankList CompleteYN="Y"><DataBank><DataBankName>ANZCTR</DataBankName><AccessionNumberList><AccessionNumber>ACTRN12613000505707</AccessionNumber></AccessionNumberList></DataBank></DataBankList><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Respir Crit Care Med</MedlineTA><NlmUniqueID>9421642</NlmUniqueID><ISSNLinking>1073-449X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>S88TT14065</RegistryNumber><NameOfSubstance UI="D010100">Oxygen</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Am J Respir Crit Care Med. 2016 Jan 1;193(1):4-5</RefSource><PMID Version="1">26720783</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>J Physiother. 2016 Jan;62(1):51</RefSource><PMID Version="1">26653676</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>J Physiother. 2016 Jan;62(1):51</RefSource><PMID Version="1">26653677</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010092" MajorTopicYN="N">Oximetry</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010100" MajorTopicYN="N">Oxygen</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010102" MajorTopicYN="N">Oxygen Inhalation Therapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010865" MajorTopicYN="N">Pilot Projects</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">critical illness</Keyword><Keyword MajorTopicYN="N">intensive care</Keyword><Keyword MajorTopicYN="N">mechanical ventilation</Keyword><Keyword MajorTopicYN="N">oxygen inhalation therapy</Keyword><Keyword MajorTopicYN="N">targets</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>9</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>9</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>5</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26334785</ArticleId><ArticleId IdType="doi">10.1164/rccm.201505-1019OC</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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