Impact of hyperoxia on patients hospitalized in an intensive care unit for acute heart failure.
Acute Disease
Aged
Aged, 80 and over
Female
Heart Failure
/ diagnosis
Hospital Mortality
Humans
Hyperoxia
/ diagnosis
Intensive Care Units
Length of Stay
Male
Middle Aged
Oxygen Inhalation Therapy
/ adverse effects
Paris
Patient Admission
Patient Readmission
Preliminary Data
Pulmonary Edema
/ diagnosis
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Heart failure
Hyperoxia
Hyperoxie
Mortality
Mortalité
OAP
Pulmonary congestion
Readmission
Réhospitalisation
USIC
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
20
06
2019
revised:
23
07
2019
accepted:
09
09
2019
pubmed:
7
11
2019
medline:
19
3
2020
entrez:
7
11
2019
Statut:
ppublish
Résumé
Oxygen therapy remains a cornerstone of treatment for acute heart failure in patients with pulmonary congestion. While avoiding hypoxaemia has long been a goal of critical care practitioners, less attention has been paid to the potential hazard related to excessive hyperoxia. To evaluate the impact of early hyperoxia exposure among critically ill patients hospitalized in an intensive care unit for acute heart failure. In this preliminary study conducted in a Parisian intensive care unit, we assessed patients with acute heart failure admitted with pulmonary congestion and treated with oxygen therapy from 1 January 2015 to 31 December 2016. The hyperoxia group was defined by having at least one partial pressure of oxygen measurement>100mmHg on the first day following admission to the intensive care unit. The primary endpoint was 30-day all-cause mortality. Secondary endpoints were 30-day unplanned hospital admissions, occurrence of infections and intensive care unit and hospital lengths of stay. Seventy-five patients were included. Forty-three patients (57.3%) presented hyperoxia, whereas 32 patients (42.7%) did not (control group). The baseline clinical characteristics did not differ between the two groups. The primary endpoint was not statistically different between the two groups (14.0% in the hyperoxia group vs 18.8% in the control group; P=0.85). The secondary endpoints were also not significantly different between the two groups. In the multivariable analysis, hyperoxia was not associated with increased 30-day mortality (odds ratio 0.77, 95% confidence interval 0.24-2.41). In patients referred to an intensive care unit for acute heart failure, we did not find any difference in outcomes according to the presence of hyperoxia.
Sections du résumé
BACKGROUND
BACKGROUND
Oxygen therapy remains a cornerstone of treatment for acute heart failure in patients with pulmonary congestion. While avoiding hypoxaemia has long been a goal of critical care practitioners, less attention has been paid to the potential hazard related to excessive hyperoxia.
AIM
OBJECTIVE
To evaluate the impact of early hyperoxia exposure among critically ill patients hospitalized in an intensive care unit for acute heart failure.
METHODS
METHODS
In this preliminary study conducted in a Parisian intensive care unit, we assessed patients with acute heart failure admitted with pulmonary congestion and treated with oxygen therapy from 1 January 2015 to 31 December 2016. The hyperoxia group was defined by having at least one partial pressure of oxygen measurement>100mmHg on the first day following admission to the intensive care unit. The primary endpoint was 30-day all-cause mortality. Secondary endpoints were 30-day unplanned hospital admissions, occurrence of infections and intensive care unit and hospital lengths of stay.
RESULTS
RESULTS
Seventy-five patients were included. Forty-three patients (57.3%) presented hyperoxia, whereas 32 patients (42.7%) did not (control group). The baseline clinical characteristics did not differ between the two groups. The primary endpoint was not statistically different between the two groups (14.0% in the hyperoxia group vs 18.8% in the control group; P=0.85). The secondary endpoints were also not significantly different between the two groups. In the multivariable analysis, hyperoxia was not associated with increased 30-day mortality (odds ratio 0.77, 95% confidence interval 0.24-2.41).
CONCLUSION
CONCLUSIONS
In patients referred to an intensive care unit for acute heart failure, we did not find any difference in outcomes according to the presence of hyperoxia.
Identifiants
pubmed: 31690520
pii: S1875-2136(19)30168-8
doi: 10.1016/j.acvd.2019.09.003
pii:
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
748-753Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.