Low versus high peripheral oxygen saturation directed oxygen therapy in critically ill patients: a multicenter randomized controlled trial

Abstract

Whether low peripheral oxygen saturation (SpO₂) directed oxygen therapy is associated with lower mortality in critically ill patients needs further exploration. Adult critically ill patients from 11 intensive care units in China were screened. Participants were randomly assigned to the low SpO₂ (90%–95%) group or the high SpO₂ (≥96%) -group. The primary outcome was 28-day all-cause mortality. The secondary outcomes were hours free from ventilators and from renal replacement therapy (RRT) within 14 days. Note that 857 patients in the low SpO₂ group and 849 in the high SpO₂ group were included. In the low SpO₂ group versus the high SpO₂ group, the time-weighted average of the fraction of inspired oxygen (FiO₂) was significantly lower (33.5 ± 9.7% vs. 39.6 ± 9.3%, p < 0.001), and so was the time-weighted average of SpO₂ (95.9 ± 1.8% vs. 98.0 ± 1.9%, p < 0.001). Within 28 days after randomization, 172 (20.1%) in the low SpO₂ group and 193 (22.7%) in the high SpO₂ group died (p = 0.180). Ventilator-free time and RRT-free time were not significantly different within 14 days. In critically ill patients, low SpO₂directed oxygen therapy did not decrease 28-day mortality, 14-day ventilator-free time, or 14-day RRT-free time.

Keywords

mechanical ventilation / mortality / oxygen therapy / partial pressure of arterial oxygen / peripheral oxygen saturation / renal replacement therapy

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