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. 2025 Feb 17;6(3):e70098.
doi: 10.1002/mco2.70098. eCollection 2025 Mar.

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

Xiaobo Yang  1 , Xuehui Gao  1 , Xiang Zheng  2 , Xu Zhao  3 , Yanli Liu  4 , Lu Zhang  5 , Junli Sun  6 , Peng Wang  7 , Zhengqin Xu  8 , Ronghua Hu  9 , Hongbin Li  10 , Hong Qi  1 , Yin Yuan  1 , Wei Chen  2 , Jie Liu  3 , Guangqing Huang  3 , Li Yu  4 , Fengsheng Cao  5 , Keke Xin  6 , Min Yu  7 , Xiaoyun Liu  8 , Li Zhang  9 , Siyuan Chang  10 , Xiaojing Zou  1 , Hong Liu  1 , Zhaohui Fu  1 , Huaqing Shu  1 , Yuan Yu  1 , Jiqian Xu  1 , Shiying Yuan  1 , You Shang  1
Affiliations

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

Xiaobo Yang et al. MedComm (2020). .

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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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of patient inclusion.
FIGURE 2
FIGURE 2
Kaplan–Meier curves demonstrating the survival probability of the low SpO2 group and the high SpO2 group. SpO2, peripheral oxygen saturation.
See this image and copyright information in PMC

References

    1. Shultz SM, Hartmann PM. George E Holtzapple (1862‐1946) and oxygen therapy for lobar pneumonia: the first reported case (1887) and a review of the contemporary literature to 1899. J Med Biogr. 2005;13(4):201‐206. - PubMed
    1. Hochberg CH, Semler MW, Brower RG. Oxygen toxicity in critically ill adults. Am J Respir Crit Care Med. 2021;204(6):632‐641. - PMC - PubMed
    1. Martin DS, Grocott MP. Oxygen therapy in critical illness: precise control of arterial oxygenation and permissive hypoxemia. Crit Care Med. 2013;41(2):423‐432. - PubMed
    1. Budinger GRS, Mutlu GM. Balancing the risks and benefits of oxygen therapy in critically III adults. Chest. 2013;143(4):1151‐1162. - PMC - PubMed
    1. Damiani E, Donati A, Girardis M. Oxygen in the critically ill: friend or foe? Curr Opin Anaesthesiol. 2018;31(2):129‐135. - PubMed

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