Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov;22(4):280-287.
doi: 10.1177/17511437211010031. Epub 2021 Apr 8.

A feasibility randomised controlled trial of targeted oxygen therapy in mechanically ventilated critically ill patients

Daniel S Martin  1   2   3 , Margaret McNeil  1 , Chris Brew-Graves  4 , Helder Filipe  1 , Ronan O'Driscoll  5   6 , Jia Liu Stevens  1   3 , Rachel Burnish  7 , Andrew F Cumpstey  7 , Norman R Williams  3 , Michael G Mythen  8 , Michael Pw Grocott  7
Affiliations

A feasibility randomised controlled trial of targeted oxygen therapy in mechanically ventilated critically ill patients

Daniel S Martin et al. J Intensive Care Soc. 2021 Nov.

Abstract

Background: Despite oxygen being the commonest drug administered to critically ill patients we do not know which oxygen saturation (SpO2) target results in optimal survival outcomes in those receiving mechanical ventilation. We therefore conducted a feasibility randomised controlled trial in the United Kingdom (UK) to assess whether it would be possible to host a larger national multi-centre trial to evaluate oxygenation targets in mechanically ventilated patients.

Methods: We set out to recruit 60 participants across two sites into a trial in which they were randomised to receive conservative oxygenation (SpO2 88-92%) or usual care (control - SpO2 ≥96%). The primary outcome was feasibility; factors related to safety and clinical outcomes were also assessed.

Results: A total of 34 patients were recruited into the study until it was stopped due to time constraints. A number of key barriers to success were identified during the course of the study. The conservative oxygenation intervention was feasible and appeared to be safe in this small patient cohort and it achieved wide separation of the median time-weighted average (IQR) SpO2 at 91% (90-92%) in conservative oxygenation group versus 97% (96-97%) in control group.

Conclusion: Whilst conservative oxygenation was a feasible and safe intervention which achieved clear group separation in oxygenation levels, the model used in this trial will require alterations to improve future participant recruitment rates in the UK.

Keywords: Oxygen; critical illness; hypoxaemia; intensive care; mechanical ventilation.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: DSM and MGM are in part funded by the UCLH/UCL NIHR Biomedical Research Centre. MPWG is in part funded by the Southampton NIHR Biomedical Research Centre.

References

    1. Martin DS, Grocott MP. Oxygen therapy in critical illness: precise control of arterial oxygenation and permissive hypoxemia. Crit Care Med 2013; 41: 423–432. - PubMed
    1. de Jonge E, Peelen L, Keijzers PJ, et al.. Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients. Crit Care 2008; 12: R156. - PMC - PubMed
    1. Schjørring OL, Jensen AKG, Nielsen CG, et al.. Arterial oxygen tensions in mechanically ventilated ICU patients and mortality: a retrospective, multicentre, observational cohort study. Br J Anaesth 2020; 124: 420–429. - PubMed
    1. Eastwood G, Bellomo R, Bailey M, et al.. Arterial oxygen tension and mortality in mechanically ventilated patients. Intensive Care Med 2012; 38: 91–98. - PubMed
    1. Palmer E, Post B, Klapaukh R, et al.. The association between supraphysiologic arterial oxygen levels and mortality in critically ill patients. A multicenter observational cohort study. Am J Respir Crit Care Med 2019; 200: 1373–1380. - PMC - PubMed