St. Emlyn´s - By Simon Carley - January 24, 2021
"Oxygen targets in critically ill/injured patients has been something we’ve talked about on the blog before. In general the evidence to date has suggested that the routine prescription of oxygen to patients is unhelpful and may well be harmful. Back in 2018, our own Dan Horner published in the BMJ on this, together with updated guidelines that advocated the prevention of ‘superoxia’ in patients. However, there was still much uncertainty as to what an appropriate target for oxygen levels are in the critically ill (and in ward patients too). This week we have new evidence presented at the Critical Care Reviews conference in Belfast, and published in the NEJM. The HOT-ICU trial is a target based randomised controlled trial of ICU patients receiving oxygen...
This is yet another study that demonstrates that high levels of oxygen are not the automatic target for critically unwell patients. The evidence for this seems to be increasingly clear. What is still uncertain is whether this applies to all patients or if there are subgroups who benefit from high or low oxygen targets. We are also not entirely clear whether an intermediate target between the levels in this paper may hold an advantage.Hopefully the MEGA-ROX and UK ROX trials will answer some of these questions, but in the interim this paper suggests that we can be more conservative with oxygen targets than we have been in the past."