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dc.contributor.authorPalmer, E
dc.contributor.authorPost, B
dc.contributor.authorKlapaukh, R
dc.contributor.authorMarra, G
dc.contributor.authorMacCallum, NS
dc.contributor.authorBrealey, D
dc.contributor.authorErcole, A
dc.contributor.authorJones, A
dc.contributor.authorAshworth, S
dc.contributor.authorWatkinson, P
dc.contributor.authorBeale, R
dc.contributor.authorBrett, SJ
dc.contributor.authorYoung, JD
dc.contributor.authorBlack, C
dc.contributor.authorRashan, A
dc.contributor.authorMartin, Daniel
dc.contributor.authorSinger, M
dc.contributor.authorHarris, S
dc.date.accessioned2020-07-09T13:17:35Z
dc.date.available2020-07-09T13:17:35Z
dc.date.issued2019-12-01
dc.identifier.issn1073-449X
dc.identifier.issn1535-4970
dc.identifier.urihttp://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.extent1373-1380
dc.format.mediumPrint
dc.languageen
dc.language.isoen
dc.publisherAmerican Thoracic Society
dc.subjectlogistic models
dc.subjectcritical care
dc.subjecthyperoxia
dc.titleThe Association between Supraphysiologic Arterial Oxygen Levels and Mortality in Critically Ill Patients. A Multicenter Observational Cohort Study
dc.typejournal-article
dc.typeJournal Article
dc.typeMulticenter Study
dc.typeObservational Study
dc.typeResearch Support, Non-U.S. Gov't
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000499728800014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue11
plymouth.volume200
plymouth.publication-statusPublished
plymouth.journalAmerican Journal of Respiratory and Critical Care Medicine
dc.identifier.doi10.1164/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.placeUnited States
dcterms.dateAccepted2019-09-12
dc.rights.embargodate2020-7-16
dc.identifier.eissn1535-4970
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1164/rccm.201904-0849oc
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-12-01
rioxxterms.typeJournal Article/Review


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