Impact of Permissive Hypoxia and Hyperoxia Avoidance on Clinical Outcomes in Septic Patients Receiving Mechanical Ventilation: A Retrospective Single-Center Study.
Journal
BioMed research international
ISSN: 2314-6141
Titre abrégé: Biomed Res Int
Pays: United States
ID NLM: 101600173
Informations de publication
Date de publication:
2021
2021
Historique:
received:
28
06
2021
revised:
11
09
2021
accepted:
21
09
2021
entrez:
25
10
2021
pubmed:
26
10
2021
medline:
9
2
2022
Statut:
epublish
Résumé
Septic patients often require mechanical ventilation due to respiratory dysfunction, and effective ventilatory strategies can improve survival. The effects of the combination of permissive hypoxia and hyperoxia avoidance for managing mechanically ventilated patients are unknown. This study examines these effects on outcomes in mechanically ventilated septic patients. In a retrospective before-and-after study, we examined adult septic patients (aged ≥18 years) requiring mechanical ventilation at a university hospital. On April 1, 2017, our mechanical ventilation policy changed from a conventional oxygenation target (SpO The postchange group did not have significantly lower adjusted ICU mortality (0.67, 0.33-1.43; Permissive hypoxia and hyperoxia avoidance had no significant association with reduced ICU mortality in mechanically ventilated septic patients. However, this approach was significantly associated with shorter mechanical ventilation duration and ICU stay, which can improve patient turnover and ventilator access.
Sections du résumé
BACKGROUND
BACKGROUND
Septic patients often require mechanical ventilation due to respiratory dysfunction, and effective ventilatory strategies can improve survival. The effects of the combination of permissive hypoxia and hyperoxia avoidance for managing mechanically ventilated patients are unknown. This study examines these effects on outcomes in mechanically ventilated septic patients.
METHODS
METHODS
In a retrospective before-and-after study, we examined adult septic patients (aged ≥18 years) requiring mechanical ventilation at a university hospital. On April 1, 2017, our mechanical ventilation policy changed from a conventional oxygenation target (SpO
RESULTS
RESULTS
The postchange group did not have significantly lower adjusted ICU mortality (0.67, 0.33-1.43;
CONCLUSIONS
CONCLUSIONS
Permissive hypoxia and hyperoxia avoidance had no significant association with reduced ICU mortality in mechanically ventilated septic patients. However, this approach was significantly associated with shorter mechanical ventilation duration and ICU stay, which can improve patient turnover and ventilator access.
Identifiants
pubmed: 34692840
doi: 10.1155/2021/7332027
pmc: PMC8531788
doi:
Substances chimiques
Oxygen
S88TT14065
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
7332027Informations de copyright
Copyright © 2021 Kota Nishimoto et al.
Déclaration de conflit d'intérêts
We declare no conflicts of interest.
Références
JAMA. 2010 Jun 2;303(21):2165-71
pubmed: 20516417
Crit Care Med. 2013 Feb;41(2):423-32
pubmed: 23263574
N Engl J Med. 2000 May 4;342(18):1301-8
pubmed: 10793162
JAMA. 2016 Oct 18;316(15):1583-1589
pubmed: 27706466
Am J Respir Crit Care Med. 1994 Jun;149(6):1550-6
pubmed: 8004312
Ann Emerg Med. 2010 Jan;55(1):40-46.e1
pubmed: 19854541
Toxicology. 2000 Nov 16;153(1-3):83-104
pubmed: 11090949
Clin Sci (Lond). 1995 Aug;89(2):165-9
pubmed: 7554757
Intensive Care Med. 2011 Jan;37(1):46-51
pubmed: 20878146
N Engl J Med. 2020 Mar 12;382(11):989-998
pubmed: 31613432
Cell Metab. 2011 Dec 7;14(6):768-79
pubmed: 22100406
Respir Care. 2013 Jan;58(1):123-41
pubmed: 23271823
JAMA. 2016 Feb 23;315(8):801-10
pubmed: 26903338
Pediatr Crit Care Med. 2014 May;15(4):e147-56
pubmed: 24413319
Acta Anaesthesiol Scand. 2018 Nov;62(10):1428-1435
pubmed: 30132782
Crit Care Med. 2014 Feb;42(2):387-96
pubmed: 24164953
Crit Care Med. 2016 Mar;44(3):554-63
pubmed: 26562347
JAMA. 2019 Feb 19;321(7):654-664
pubmed: 30772908
Am J Respir Crit Care Med. 2016 Jan 1;193(1):43-51
pubmed: 26334785
Dimens Crit Care Nurs. 2013 Sep-Oct;32(5):222-8
pubmed: 23933639
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452
BMJ Open. 2019 Jan 17;9(1):e021674
pubmed: 30659035
Biomed Res Int. 2018 May 14;2018:7841295
pubmed: 29888278
Acta Anaesthesiol Scand. 2020 Jul;64(6):847-856
pubmed: 32068884
Cochrane Database Syst Rev. 2013 Feb 28;(2):CD003844
pubmed: 23450544
Crit Care Med. 2014 Jun;42(6):1414-22
pubmed: 24561566
Am J Respir Crit Care Med. 2016 Aug 15;194(4):402-14
pubmed: 27337068
Breathe (Sheff). 2015 Sep;11(3):194-201
pubmed: 26632351
Intensive Care Med. 2020 Jan;46(1):17-26
pubmed: 31748836