Oxygenation targets in ICU patients with COVID-19: A post hoc subgroup analysis of the HOT-ICU trial.
intensive care units
oxygen inhalation therapy
randomized controlled trial
respiratory insufficiency
severe acute respiratory syndrome coronavirus 2
Journal
Acta anaesthesiologica Scandinavica
ISSN: 1399-6576
Titre abrégé: Acta Anaesthesiol Scand
Pays: England
ID NLM: 0370270
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
revised:
10
08
2021
received:
23
06
2021
accepted:
13
08
2021
pubmed:
24
8
2021
medline:
30
12
2021
entrez:
23
8
2021
Statut:
ppublish
Résumé
Supplemental oxygen is the key intervention for severe and critical COVID-19 patients. With the unstable supplies of oxygen in many countries, it is important to define the lowest safe dosage. In spring 2020, 110 COVID-19 patients were enrolled as part of the Handling Oxygenation Targets in the ICU trial (HOT-ICU). Patients were allocated within 12 h of ICU admission. Oxygen therapy was titrated to a partial pressure of arterial oxygen (PaO At 90 days, 22 of 54 patients (40.7%) in the lower oxygenation group and 23 of 55 patients (41.8%) in the higher oxygenation group had died (adjusted risk ratio: 0.87; 95% confidence interval, 0.58-1.32). The percentage of days alive without life support was significantly higher in the lower oxygenation group (p = 0.03). The numbers of severe ischemic events were low with no difference between the two groups. Proning and inhaled vasodilators were used more frequently, and the positive end-expiratory pressure was higher in the higher oxygenation group. Tests for interactions with the results of the remaining HOT-ICU population were insignificant. Targeting a PaO ClinicalTrials.gov number, NCT03174002. Date of registration: June 2, 2017.
Sections du résumé
BACKGROUND
Supplemental oxygen is the key intervention for severe and critical COVID-19 patients. With the unstable supplies of oxygen in many countries, it is important to define the lowest safe dosage.
METHODS
In spring 2020, 110 COVID-19 patients were enrolled as part of the Handling Oxygenation Targets in the ICU trial (HOT-ICU). Patients were allocated within 12 h of ICU admission. Oxygen therapy was titrated to a partial pressure of arterial oxygen (PaO
RESULTS
At 90 days, 22 of 54 patients (40.7%) in the lower oxygenation group and 23 of 55 patients (41.8%) in the higher oxygenation group had died (adjusted risk ratio: 0.87; 95% confidence interval, 0.58-1.32). The percentage of days alive without life support was significantly higher in the lower oxygenation group (p = 0.03). The numbers of severe ischemic events were low with no difference between the two groups. Proning and inhaled vasodilators were used more frequently, and the positive end-expiratory pressure was higher in the higher oxygenation group. Tests for interactions with the results of the remaining HOT-ICU population were insignificant.
CONCLUSIONS
Targeting a PaO
TRIAL REGISTRATION NUMBER
ClinicalTrials.gov number, NCT03174002. Date of registration: June 2, 2017.
Identifiants
pubmed: 34425016
doi: 10.1111/aas.13977
pmc: PMC8653379
doi:
Banques de données
ClinicalTrials.gov
['NCT03174002']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
76-84Subventions
Organisme : Det Obelske Familiefond
ID : 27970
Organisme : Regions of Denmark
ID : EMN-2017-00901
Organisme : Regions of Denmark
ID : EMN-2019-01055
Organisme : Innovationsfonden
ID : 4108-00011A
Informations de copyright
© 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
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