Conservative Oxygen Therapy during Mechanical Ventilation in the ICU
Open accessAbstract
BACKGROUND: ) and have a high arterial oxygen tension. The conservative use of oxygen may reduce oxygen exposure, diminish lung and systemic oxidative injury, and thereby increase the number of ventilator-free days (days alive and free from mechanical ventilation). METHODS: . The primary outcome was the number of ventilator-free days from randomization until day 28. RESULTS: exceeding 96%, with a duration of 27 hours (interquartile range, 11 to 63.5) and 49 hours (interquartile range, 22 to 112), respectively (absolute difference, 22 hours; 95% CI, 14 to 30). At 180 days, mortality was 35.7% in the conservative-oxygen group and 34.5% in the usual-oxygen group, for an unadjusted odds ratio of 1.05 (95% CI, 0.81 to 1.37). CONCLUSIONS: In adults undergoing mechanical ventilation in the ICU, the use of conservative oxygen therapy, as compared with usual oxygen therapy, did not significantly affect the number of ventilator-free days. (Funded by the Health Research Council of New Zealand; ICU-ROX Australian and New Zealand Clinical Trials Registry number, ACTRN12615000957594.).
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In the ICU-ROX trial, mortality at 90 and 180 days did not differ between conservative and liberal oxygen therapy.
“Mortality at 90 and 180 days did not differ.”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [405]
The evidence for the use of conservative oxygen targets and therapy in patients with sepsis is limited, with three randomised trials in the critically ill population.
“The evidence for the use of conservative oxygen targets (generally defined as PaO2 55–70 mmHg; SpO2 88–92%) and therapy in patients with sepsis is limited, with three randomised trials in the critically ill population [404–406].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [405]
In the 1000-participant ICU-ROX trial, conservative oxygen therapy did not significantly affect the primary outcome (ventilator-free days) compared with liberal oxygen therapy for ventilated adults in ICU.
“In the 1000-participant ICU-ROX trial [405], conservative oxygen therapy did not significantly affect the primary outcome, which was the number of ventilator-free days, compared with liberal oxygen therapy for ventilated adults in ICU.”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [405]
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- Authors
- The ICU-ROX Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- The ICU-ROX Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2020-03-12
- Volume
- 382
- Issue
- 11
- Pages
- 989-998
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2980403271
- Cited by
- 511
- References
- 25
- Citations by year
- 2026: 43 · 2025: 57 · 2024: 66 · 2023: 76 · 2022: 90 · 2021: 99 · 2020: 73 · 2019: 6 · 2015: 1
- FWCI
- 49.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Funders
- Health Research Council of New Zealand (16/014)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- conservative oxygen therapy, mechanical ventilation, intensive care unit patients, ventilator-free days, oxygen saturation, oxidative lung injury, mortality
- MeSH terms
- Conservative Treatment, Adult, Aged, Female, Humans, Intensive Care Units, Male, Middle Aged, Oxygen, Oxygen Inhalation Therapy, Respiration, Artificial, Ventilator Weaning, Treatment Outcome
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