https://doi.org/10.4081/monaldi.2023.2536
Conservative versus conventional oxygen therapy in type I acute respiratory failure patients in respiratory intensive care unit, Zagazig University
Submitted: January 29, 2023
Accepted: April 26, 2023
Published: May 5, 2023
Accepted: April 26, 2023
Abstract Views: 776
PDF: 371
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The present study aimed to assess the effect of a conservative (permissive hypoxemia) versus conventional (normoxia) protocol for oxygen supplementation on the outcome of type I respiratory failure patients admitted to respiratory intensive care unit (ICU). This randomized controlled clinical trial was carried out at the Respiratory ICU, Chest Department of Zagazig University Hospital, for 18 months, starting in July 2018. On admission, 56 enrolled patients with acute respiratory failure were randomized in a 1:1 ratio into the conventional group [oxygen therapy was supplied to maintain oxygen saturation (SpO2) between 94% and 97%] and the conservative group (oxygen therapy was administered to maintain SpO2 values between 88% and 92%). Different outcomes were assessed, including ICU mortality, the need for mechanical ventilation (MV) (invasive or non-invasive), and ICU length of stay. In the current study, the partial pressure of oxygen was significantly higher among the conventional group at all times after the baseline reading, and bicarbonate was significantly higher among the conventional group at the first two readings. There was no significant difference in serum lactate level in follow-up readings. The mean duration of MV and ICU length of stay was 6.17±2.05 and 9.25±2.22 days in the conventional group versus 6.46±2.0 and 9.53±2.16 days in the conservative group, respectively, without significant differences between both groups. About 21.4% of conventional group patients died, while 35.7% of conservative group patients died without a significant difference between both groups. We concluded that conservative oxygen therapy may be applied safely to patients with type I acute respiratory failure.
Dong WH, Yan WQ, Chen Z. Effect of liberal or conservative oxygen therapy on the prognosis for mechanically ventilated intensive care unit patients: a meta-analysis. Sao Paulo Med J 2022;140:463-73.
O’Driscoll BR, Howard LS, Earis J, Mak V. British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Respir Res 2017;4:e000170.
Li X, Liu D, Liu C, et al. Conservative versus liberal oxygen therapy in relation to all-cause mortality among patients in the intensive care unit: a systematic review of randomized controlled trials with meta-analysis and trial sequential analysis. Med Intensiva (Engl Ed) 2023;47:73-83.
Chu DK, Kim LH, Young PJ, et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet 2018;391:1693-705.
Budinger GRS, Mutlu GM. Balancing the risks and benefits of oxygen therapy in critically III adults. Chest 2013;143:1151-62.
Damiani E, Donati A, Girardis M. Oxygen in the critically ill: friend or foe?. Curr Opin Anaesthesiol 2018;31:129-35.
Helmerhorst HJ, Roos-Blom MJ, van Westerloo DJ, de Jonge E. Association between arterial hyperoxia and outcome in subsets of critical illness: a systematic review, meta-analysis, and meta-regression of cohort studies. Crit Care Med 2015;43:1508-19.
Barbateskovic M, Schjørring OL, Russo Krauss S, et al. Higher versus lower fraction of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit. Cochrane Database Syst Rev 2019;2019:CD012631.
Hirase T, Ruff ES, Ratnani I, Surani SR. Impact of conservative versus conventional oxygenation on outcomes of patients in intensive care units: a systematic review and meta-analysis. Cureus 2019;11:e5662.
Mackle D, Bellomo R, Bailey M, et al. Conservative oxygen therapy during mechanical ventilation in the ICU. New Engl J Med 2020;382:989-98.
Schjørring OL, Klitgaard TL, Perner A, et al. Lower or higher oxygenation targets for acute hypoxemic respiratory failure. N Engl J Med 2021;384:1301-11.
Panwar R, Hardie M, Bellomo R, et al. Conservative versus liberal oxygenation targets for mechanically ventilated patients. A pilot multicenter randomized controlled trial. Am J Respir Crit Care Med 2016;193:43-51.
Barrot L, Asfar P, Mauny F, et al. Liberal or conservative oxygen therapy for acute respiratory distress syndrome. New Engl J Med 2020;382:999-1008.
Metnitz PG, Moreno RP, Almeida E, et al. SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 1: objectives, methods and cohort description. Intensive Care Med 2005;31:1336-44.
Futier E, Robin E, Jabaudon M, et al. Central venous O₂ saturation and venous-to-arterial CO₂ difference as complementary tools for goal-directed therapy during high-risk surgery. Crit Care 2010;14:R193.
Martin DS, Grocott MP. Oxygen therapy in critical illness: precise control of arterial oxygenation and permissive hypoxemia. Crit Care Med 2013;41:423-32.
Gilbert-Kawai ET, Mitchell K, Martin D, et al. Permissive hypoxaemia versus normoxaemia for mechanically ventilated critically ill patients. Cochrane Database Syst Rev 2014;2014:CD009931.
Chen XL, Zhang BL, Meng C, et al. Conservative oxygen therapy for critically ill patients: a meta-analysis of randomized controlled trials. J Intensive Care 2021;9:47.
Girardis M, Busani S, Damiani E, et al. Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA 2016;316:1583-9.
Lång M, Skrifvars MB, Siironen J, et al. A pilot study of hyperoxemia on neurological injury, inflammation and oxidative stress. Acta Anaesthesiol Scand 2018 62:801-10.
Jakkula P, Reinikainen M, Hästbacka J, et al. Targeting two different levels of both arterial carbon dioxide and arterial oxygen after cardiac arrest and resuscitation: a randomised pilot trial. Intensive Care Med 2018;44:2112-21.
Yang X, Shang Y, Yuan S. Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study. J Thorac Dis 2019;11:4234-40.
He HW, Liu DW, Long Y, Wang XT. High central venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio is associated with poor lactate clearance in septic patients after resuscitation. J Crit Care 2016;31:76-81.
Yuan S, He H, Long Y. Interpretation of venous-to-arterial carbon dioxide difference in the resuscitation of septic shock patients. J Thorac Dis 2019;11:S1538-43.
Suzuki S, Eastwood GM, Glassford NJ, et al. Conservative oxygen therapy in mechanically ventilated patients: a pilot before-and-after trial. Crit Care Med 2014;42:1414-22.
Memet O, Zhang L, Shen J. Serological biomarkers for acute mesenteric ischemia. Ann Transl Med 2019;7:394.
Schmidt B, Whyte RK, Asztalos EV, et al. Effects of targeting higher vs lower arterial oxygen saturations on death or disability in extremely preterm infants: a randomized clinical trial. JAMA 2013;309:2111-20.
Iobbi MG, Simonds AK, Dickinson RJ. Oximetry feedback flow control simulation for oxygen therapy. J Clin Monit Comput 2007;21:115-23.
Zhao X, Xiao H, Dai F, et al. Classification and effectiveness of different oxygenation goals in mechanically ventilated critically ill patients: network meta-analysis of randomised controlled trials. Eur Respir J 2021;58:2002928.
Ethics Approval
Ethical approval to perform this study was gained from the Zagazig University-Institutional Review Board (ZU-IRB No. 4719/25-6-2018)How to Cite
Nafae, Ramadan M., Waheed Shouman, Salwa H. Abdelmoneam, and Samah M. Shehata. 2023. “Conservative <i>versus< i> Conventional Oxygen Therapy in Type I Acute Respiratory Failure Patients in Respiratory Intensive Care Unit, Zagazig University”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2536.
Copyright (c) 2023 The Author(s)
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