Conservative or liberal oxygen therapy for mechanically ventilated adults with acute brain pathologies: A post-hoc subgroup analysis

Young, Paul J.; Mackle, Diane; King, Victoria; Linke, Natalie; Litton, Edward; McArthur, Colin; McGuinness, Shay; Panwar, Rakshit; Hodgson, Carol; Bellomo, Rinaldo; Bailey, Michael; Beasley, Richard; Deane, Adam M.; Eastwood, Glenn; Finfer, Simon; Freebairn, Ross

Title: Conservative or liberal oxygen therapy for mechanically ventilated adults with acute brain pathologies: A post-hoc subgroup analysis
Creator: Young, Paul J.; Mackle, Diane; King, Victoria; Linke, Natalie; Litton, Edward; McArthur, Colin; McGuinness, Shay; Panwar, Rakshit; Hodgson, Carol; Bellomo, Rinaldo; Bailey, Michael; Beasley, Richard; Deane, Adam M.; Eastwood, Glenn; Finfer, Simon; Freebairn, Ross
Relation: Journal of Neuroimmunology Vol. 71, Issue October 2022, no. 154079
Publisher Link: http://dx.doi.org/10.1016/j.jcrc.2022.154079
Publisher: Elsevier
Resource Type: journal article
Date: 2022
Description: Purpose: To compare the effect of conservative vs. liberal oxygen therapy in mechanically ventilated adults in the intensive care unit (ICU) with non-hypoxic ischemic encephalopathy (HIE) acute brain pathologies. Materials and methods: Post-hoc analysis of data from 217 patients with non-HIE acute brain pathologies included in the ICU Randomized Trial Comparing Two Approaches to OXygen therapy (ICU-ROX). Results: Patients allocated to conservative oxygen spent less time with oxygen saturation ≥ 97% (50.5 [interquartile range (IQR), 18.5–119] vs. 82 h [IQR, 38–164], absolute difference, −31.5 h; 95%CI, −59.6 to −3.4). At 180 days, 38 of 110 conservative oxygen patients (34.5%) and 28 of 104 liberal oxygen patients (26.9%) had died (absolute difference, 7.6 percentage points; 95%CI, −4.7 to 19.9 percentage points; P = 0.23; interaction P = 0.02 for non-HIE acute brain pathologies vs. HIE; interaction P = 0.53 for non-HIE acute brain pathologies vs. non-neurological conditions). Conclusions: In this post-hoc analysis, patients admitted to the ICU with non-HIE acute brain pathologies treated with conservative oxygen therapy did not have significantly lower mortality than those treated with liberal oxygen. A trial with adequate statistical power is needed to determine whether our day 180 mortality point estimate of treatment effect favoring liberal oxygen therapy indicates a true effect.
Subject: oxygen therapy; hyperoxia; hypoxia; subarachnoid hemorrhage; traumatic brain injury; stroke; SDG 3; Sustainable Development Goals
Identifier: http://hdl.handle.net/1959.13/1465832
Identifier: uon:47387
Identifier: ISSN:0883-9441
Language: eng
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