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Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: a retrospective nested cohort study

Eastwood, Glenn M., Tanaka, Aiko, Espinoza, Emilo Daniel Valenzuela, Peck, Leah, Young, Helen, Mårtensson, Johan, Zhang, Ling, Glassford, Neil J., Hsiao, Yu-Feng Frank, Suzuki, Satoshi and Bellomo, Rinoldo 2016, Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: a retrospective nested cohort study, Resuscitation, vol. 101, pp. 108-114, doi: 10.1016/j.resuscitation.2015.11.026.

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Title Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: a retrospective nested cohort study
Author(s) Eastwood, Glenn M.
Tanaka, Aiko
Espinoza, Emilo Daniel Valenzuela
Peck, Leah
Young, Helen
Mårtensson, Johan
Zhang, Ling
Glassford, Neil J.
Hsiao, Yu-Feng Frank
Suzuki, Satoshi
Bellomo, Rinoldo
Journal name Resuscitation
Volume number 101
Start page 108
End page 114
Total pages 7
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-04
ISSN 0300-9572
1873-1570
Keyword(s) oxygen
cardiac arrest
mechanical ventilation
mortality
outcome
intensive care
Summary Background: In mechanically ventilated (MV) cardiac arrest (CA) survivors admitted to the intensive care unit (ICU) avoidance of hypoxia is considered crucial. However, avoidance of hyperoxia may also be important. A conservative approach to oxygen therapy may reduce exposure to both. Methods: We evaluated the introduction of conservative oxygen therapy (target SpO2 88-92% using the lowest FiO2) during MV for resuscitated CA patients admitted to the ICU. Results: We studied 912 arterial blood gas (ABG) datasets: 448 ABGs from 50 'conventional' and 464 ABGs from 50 'conservative' oxygen therapy patients. Compared to the conventional group, conservative group patients had significantly lower PaO2 values and FiO2 exposure (p <0.001, respectively); more received MV in a spontaneous ventilation mode (18% vs 2%; p =0.001) and more were exposed to a FiO 2 of 0.21 (19 vs 0 patients, p =0.001). Additionally, according to mean PaO2, more conservative group patients were classified as normoxaemic (36 vs 16 patients, p <0.01) and fewer as hyperoxaemic (14 vs 33 patients, p <0.01). Finally, ICU length of stay was significantly shorter for conservative group patients (p =0.04). There was no difference in the proportion of survivors discharged from hospital with good neurological outcome (14/23 vs 12/22 patients, p =0.67). Conclusions: Our findings provide preliminary support for the feasibility and physiological safety of conservative oxygen therapy in patients admitted to ICU for MV support after cardiac arrest (Trial registration, NCT01684124).
Language eng
DOI 10.1016/j.resuscitation.2015.11.026
Field of Research 1103 Clinical Sciences
1117 Public Health And Health Services
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Elsevier Ireland
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080843

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.