Arterial oxygen pressure targets in critically ill patients: Analysis of a large ICU database |
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| Affiliation: | 1. Emergency Intensive Care Unit, Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, PR China;2. Department of Intensive Care Unit, Yiwu Hospital Affiliated to Wenzhou Medical University, Yiwu 322000, PR China;3. Department of Nephrology, Yiwu Hospital Affiliated to Wenzhou Medical University, Yiwu 322000, PR China;1. Department of Medical Biochemistry& Molecular Biology, Faculty of Medicine, Assiut University, Egypt;2. Department of Cardiology, Faculty of Medicine, Assiut University, Egypt;1. Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, P.zza Giulio Cesare, 11 70124 Bari, Italy;2. Thoracic Surgery Unit, Department of Cardiologic, Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy;3. Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca'' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy;4. Thoracic Surgery Unit, ''V Fazzi'' Hospital, Lecce, Italy;1. Department of Internal Medicine, McGovern Medical School, Houston, TX, USA;2. Department of Advanced Cardiopulmonary Therapeutics and Transplantation, McGovern Medical School, Houston, TX, USA;3. Department of Internal Medicine: Renal Diseases and Hypertension, McGovern Medical School, Houston, TX, USA;4. Department of Internal Medicine: Pulmonary, Critical Care and Sleep Medicine, McGovern Medical School, FCCP, 6431 Fannin St MSB 1.268, 77030 Houston, TX, USA;1. Norwich Medical School, University of East Anglia, Norwich, United Kingdom;2. Royal Brompton Hospital and Imperial College London, United Kingdom;3. Norfolk and Norwich University Hospital, Norwich, United Kingdom;1. Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran;2. Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, North Kargar St., Tehran 14117, Iran;3. Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran;4. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, USA;1. Intensive Care Unit, Poissy Saint Germain Hospital, 9-10 rue du champ Gaillard, Poissy 78300, France;2. Medical Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France;3. INSERM U-1018, CESP, Team “Epidemiologie Clinique”, UVSQ, Villejuif, France |
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| Abstract: | BackgroundProviding supplemental oxygen is common in the management of critically ill patients, yet the optimal oxygen regimen remains unclear.ObjectivesTo explore the optimal range of PaO2 in critically ill patients.MethodsThis is a retrospective study conducted in the Medical Information Mart for Intensive Care III (MIMIC-III) database. The patients with a least 48 h of oxygen therapy were included. Nonlinear regression was used to analyze the association between PaO2 and mortality. We derived an optimal range of PaO2 and evaluated the association between the proportion of PaO2 measurements within this range and mortality.ResultsIn total, 8401 patients were included in the study. A J-shaped relationship was observed between median PaO2 and hospital mortality. Compared with the reference group of 100–120 mmHg, patients with values of 80–100 mmHg and 120–140 mmHg had higher hospital mortality (adjusted odds ratio [aOR], 1.23; 95% CI, 1.05–1.43 and 1.29; 95%CI, 1.08–1.54, respectively). Similarly, mortality rates were significantly higher for PaO2 <80 mmHg and ≥140 mmHg (aOR, 1.97; 95%CI, 1.58–2.45 and 1.42; 95%CI, 1.19–1.69, respectively). Patients spent a greater proportion of time within 100–120 mmHg tended to have a lower mortality rate.ConclusionAmong critically ill patients, the relationship between median PaO2 and hospital mortality was J-shaped. The lowest rates of mortality was observed in those with PaO2 levels within 100 to 120 mmHg. |
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