Higher versus lower oxygenation strategies in the general intensive care unit population: A systematic review, meta-analysis and meta-regression of randomized controlled trials
Issued Date
2022-12-01
Resource Type
ISSN
08839441
eISSN
15578615
Scopus ID
2-s2.0-85138804138
Pubmed ID
36182731
Journal Title
Journal of Critical Care
Volume
72
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Critical Care Vol.72 (2022)
Suggested Citation
van der Wal L.I., Grim C.C.A., van Westerloo D.J., Schultz M.J., de Jonge E., Helmerhorst H.J.F. Higher versus lower oxygenation strategies in the general intensive care unit population: A systematic review, meta-analysis and meta-regression of randomized controlled trials. Journal of Critical Care Vol.72 (2022). doi:10.1016/j.jcrc.2022.154151 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85252
Title
Higher versus lower oxygenation strategies in the general intensive care unit population: A systematic review, meta-analysis and meta-regression of randomized controlled trials
Other Contributor(s)
Abstract
Purpose: Oxygen therapy is vital in adult intensive care unit (ICU) patients, but it is indistinct whether higher or lower oxygen targets are favorable. Our aim was to update the findings of randomized controlled trials (RTCs) comparing higher and lower oxygen strategies. Materials and methods: MEDLINE, EMBASE, and Web of Science were searched. RCTs comparing higher (liberal, hyperoxia) and lower (conservative, normoxia) oxygen in adult mechanically ventilated ICU patients were included. The main outcome was 90-day mortality; other outcomes include serious adverse events (SAE), support free days and length of stay (LOS). Results: No significant difference was observed for 90-day mortality. A lower incidence was found for SAEs, favoring lower oxygenation (OR, 0.86; 95%CI, 0.77–0.96; I 2 13%). No differences were observed in either support free days at day 28 or ICU and hospital LOS. Conclusions: No difference was found for 90-day mortality, support free days and ICU and hospital LOS. However, a lower incidence of SAEs was found for lower oxygenation. These findings may have clinical implications for practice guidelines, yet it remains of paramount importance to continue conducting clinical trials, comparing groups with a clinically relevant contrast and focusing on the impact of important side effects.