Conservative vs. Liberal Oxygen Therapy in Sepsis
Trial question
What is the effect of conservative oxygen therapy in mechanically ventilated patients with sepsis?
Study design
Single center
Single blinded
RCT
Population
Characteristics of study participants
35.0% female
65.0% male
N = 106
106 patients (37 female, 69 male).
Inclusion criteria: adult patients with sepsis undergoing mechanical ventilation.
Key exclusion criteria: age < 18 years; pregnancy; ARDS; COPD; idiopathic pulmonary fibrosis; CVD; CKD; no informed consent.
Interventions
N=53 conservative oxygen strategy (target SaO2 of 88-92%).
N=53 liberal oxygen strategy (target SaO2 of ≥ 96%).
Primary outcome
Stroke volume at 72 hours
58.26 mL
56.79 mL
58.3 mL
43.7 mL
29.1 mL
14.6 mL
0.0 mL
Conservative oxygen
strategy
Liberal oxygen
strategy
No significant
difference ↔
No significant difference in stroke volume at 72 hours (58.26 mL vs. 56.79 mL; AD 1.47 mL, 95% CI -2.35 to 5.29).
Secondary outcomes
No significant difference in cardiac output at 72 hours (5.85 L/min vs. 5.75 L/min; AD 0.1 L/min, 95% CI -0.3 to 0.5).
Significant increase in vasopressor use (84.9% vs. 66%; AD 18.9%, 95% CI 2.46 to 35.34).
No significant difference in mean length of ICU stay (14 days vs. 13.38 days; AD 0.62 days, 95% CI -1.13 to 2.37).
Safety outcomes
No significant difference in adverse events.
Conclusion
In adult patients with sepsis undergoing mechanical ventilation, conservative oxygen strategy was not superior to liberal oxygen strategy with respect to stroke volume at 72 hours.
Reference
Huda F Ghazaly, Ahmed Alsaied A Aly, Ahmed S Tammam et al. Influence of liberal versus conservative oxygen therapies on the hemodynamic parameters of mechanically ventilated patients with sepsis: a randomized clinical trial. BMC Anesthesiol. 2024 Dec 20;24(1):469.
Open reference URL