Liberal or Conservative Oxygen Therapy for Acute Respiratory Distress Syndrome.
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
12 03 2020
12 03 2020
Historique:
entrez:
12
3
2020
pubmed:
12
3
2020
medline:
17
3
2020
Statut:
ppublish
Résumé
In patients with acute respiratory distress syndrome (ARDS), the National Heart, Lung, and Blood Institute ARDS Clinical Trials Network recommends a target partial pressure of arterial oxygen (Pao In this multicenter, randomized trial, we assigned patients with ARDS to receive either conservative oxygen therapy (target Pao After the enrollment of 205 patients, the trial was prematurely stopped by the data and safety monitoring board because of safety concerns and a low likelihood of a significant difference between the two groups in the primary outcome. Four patients who did not meet the eligibility criteria were excluded. At day 28, a total of 34 of 99 patients (34.3%) in the conservative-oxygen group and 27 of 102 patients (26.5%) in the liberal-oxygen group had died (difference, 7.8 percentage points; 95% confidence interval [CI], -4.8 to 20.6). At day 90, 44.4% of the patients in the conservative-oxygen group and 30.4% of the patients in the liberal-oxygen group had died (difference, 14.0 percentage points; 95% CI, 0.7 to 27.2). Five mesenteric ischemic events occurred in the conservative-oxygen group. Among patients with ARDS, early exposure to a conservative-oxygenation strategy with a Pao
Sections du résumé
BACKGROUND
In patients with acute respiratory distress syndrome (ARDS), the National Heart, Lung, and Blood Institute ARDS Clinical Trials Network recommends a target partial pressure of arterial oxygen (Pao
METHODS
In this multicenter, randomized trial, we assigned patients with ARDS to receive either conservative oxygen therapy (target Pao
RESULTS
After the enrollment of 205 patients, the trial was prematurely stopped by the data and safety monitoring board because of safety concerns and a low likelihood of a significant difference between the two groups in the primary outcome. Four patients who did not meet the eligibility criteria were excluded. At day 28, a total of 34 of 99 patients (34.3%) in the conservative-oxygen group and 27 of 102 patients (26.5%) in the liberal-oxygen group had died (difference, 7.8 percentage points; 95% confidence interval [CI], -4.8 to 20.6). At day 90, 44.4% of the patients in the conservative-oxygen group and 30.4% of the patients in the liberal-oxygen group had died (difference, 14.0 percentage points; 95% CI, 0.7 to 27.2). Five mesenteric ischemic events occurred in the conservative-oxygen group.
CONCLUSIONS
Among patients with ARDS, early exposure to a conservative-oxygenation strategy with a Pao
Identifiants
pubmed: 32160661
doi: 10.1056/NEJMoa1916431
doi:
Substances chimiques
Oxygen
S88TT14065
Banques de données
ClinicalTrials.gov
['NCT02713451']
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
999-1008Investigateurs
P Asfar
(P)
F Beloncle
(F)
P M Fayolle
(PM)
A Kouatchet
(A)
T H Mezdad
(TH)
P Y Olivier
(PY)
M Pierrot
(M)
V Souday
(V)
A L Merel
(AL)
F Montini
(F)
S Moschietto
(S)
R Simon
(R)
J Badie
(J)
L Barrot
(L)
N Belin
(N)
G Besch
(G)
Y Brunin
(Y)
L Carteron
(L)
C Chaignat
(C)
M Claveau
(M)
F Claude
(F)
G Capellier
(G)
G Labro
(G)
J C Navellou
(JC)
J Paillot
(J)
C Patry
(C)
S Pili Floury
(S)
G Piton
(G)
H Winiszewski
(H)
J M Constantin
(JM)
T Godet
(T)
A Lemaire
(A)
E Soum
(E)
B Souweine
(B)
P Andreu
(P)
B Bouhemad
(B)
N Nowobilski
(N)
J P Quenot
(JP)
A Kimmoun
(A)
M Koszutski
(M)
B Levy
(B)
R Gaci
(R)
G Louis
(G)
O Collange
(O)
J Pottecher
(J)
A Roche
(A)
F Mauny
(F)
M Puyraveau
(M)
L Vettoretti
(L)
R Soichez
(R)
M B Valnet-Rabier
(MB)
S Jaber
(S)
C Mélot
(C)
L Papazian
(L)
S Pierre
(S)
Commentaires et corrections
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Informations de copyright
Copyright © 2020 Massachusetts Medical Society.