The Association between Supraphysiologic Arterial Oxygen Levels and Mortality in Critically Ill Patients. A Multicenter Observational Cohort Study
dc.contributor.author | Palmer, E | |
dc.contributor.author | Post, B | |
dc.contributor.author | Klapaukh, R | |
dc.contributor.author | Marra, G | |
dc.contributor.author | MacCallum, NS | |
dc.contributor.author | Brealey, D | |
dc.contributor.author | Ercole, A | |
dc.contributor.author | Jones, A | |
dc.contributor.author | Ashworth, S | |
dc.contributor.author | Watkinson, P | |
dc.contributor.author | Beale, R | |
dc.contributor.author | Brett, SJ | |
dc.contributor.author | Young, JD | |
dc.contributor.author | Black, C | |
dc.contributor.author | Rashan, A | |
dc.contributor.author | Martin, Daniel | |
dc.contributor.author | Singer, M | |
dc.contributor.author | Harris, S | |
dc.date.accessioned | 2020-07-09T13:17:35Z | |
dc.date.available | 2020-07-09T13:17:35Z | |
dc.date.issued | 2019-12-01 | |
dc.identifier.issn | 1073-449X | |
dc.identifier.issn | 1535-4970 | |
dc.identifier.uri | http://hdl.handle.net/10026.1/15935 | |
dc.description.abstract |
Rationale: There is conflicting evidence on harm related to exposure to supraphysiologic PaO2 (hyperoxemia) in critically ill patients.Objectives: To examine the association between longitudinal exposure to hyperoxemia and mortality in patients admitted to ICUs in five United Kingdom university hospitals.Methods: A retrospective cohort of ICU admissions between January 31, 2014, and December 31, 2018, from the National Institute of Health Research Critical Care Health Informatics Collaborative was studied. Multivariable logistic regression modeled death in ICU by exposure to hyperoxemia.Measurements and Main Results: Subsets with oxygen exposure windows of 0 to 1, 0 to 3, 0 to 5, and 0 to 7 days were evaluated, capturing 19,515, 10,525, 6,360, and 4,296 patients, respectively. Hyperoxemia dose was defined as the area between the PaO2 time curve and a boundary of 13.3 kPa (100 mm Hg) divided by the hours of potential exposure (24, 72, 120, or 168 h). An association was found between exposure to hyperoxemia and ICU mortality for exposure windows of 0 to 1 days (odds ratio [OR], 1.15; 95% compatibility interval [CI], 0.95-1.38; P = 0.15), 0 to 3 days (OR 1.35; 95% CI, 1.04-1.74; P = 0.02), 0 to 5 days (OR, 1.5; 95% CI, 1.07-2.13; P = 0.02), and 0 to 7 days (OR, 1.74; 95% CI, 1.11-2.72; P = 0.02). However, a dose-response relationship was not observed. There was no evidence to support a differential effect between hyperoxemia and either a respiratory diagnosis or mechanical ventilation.Conclusions: An association between hyperoxemia and mortality was observed in our large, unselected multicenter cohort. The absence of a dose-response relationship weakens causal interpretation. Further experimental research is warranted to elucidate this important question. | |
dc.format.extent | 1373-1380 | |
dc.format.medium | ||
dc.language | en | |
dc.language.iso | en | |
dc.publisher | American Thoracic Society | |
dc.subject | logistic models | |
dc.subject | critical care | |
dc.subject | hyperoxia | |
dc.title | The Association between Supraphysiologic Arterial Oxygen Levels and Mortality in Critically Ill Patients. A Multicenter Observational Cohort Study | |
dc.type | journal-article | |
dc.type | Journal Article | |
dc.type | Multicenter Study | |
dc.type | Observational Study | |
dc.type | Research Support, Non-U.S. Gov't | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000499728800014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.issue | 11 | |
plymouth.volume | 200 | |
plymouth.publication-status | Published | |
plymouth.journal | American Journal of Respiratory and Critical Care Medicine | |
dc.identifier.doi | 10.1164/rccm.201904-0849oc | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/Faculty of Health/Peninsula Medical School | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine | |
plymouth.organisational-group | /Plymouth/Users by role | |
plymouth.organisational-group | /Plymouth/Users by role/Academics | |
dc.publisher.place | United States | |
dcterms.dateAccepted | 2019-09-12 | |
dc.rights.embargodate | 2020-7-16 | |
dc.identifier.eissn | 1535-4970 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1164/rccm.201904-0849oc | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2019-12-01 | |
rioxxterms.type | Journal Article/Review |