Liberal or Conservative Oxygen Therapy for Acute Respiratory Distress Syndrome

Loïc Barrot(Université d'Angers), Pierre Asfar(Université d'Angers), Frédéric Mauny(Inserm), Hadrien Winiszewski(Université d'Angers), Florent Montini(Université d'Angers), Julio Badié(Université d'Angers), Jean‐Pierre Quenot(Université d'Angers), Sébastien Pili‐Floury(Université d'Angers), Bélaïd Bouhemad(Université d'Angers), Guillaume Louis(Université d'Angers), Bertrand Souweine(Intensive Care Society), Olivier Collange(Université d'Angers), Julien Pottecher(Université d'Angers), Bruno Lévy(Centre Hospitalier Régional et Universitaire de Nancy), Marc Puyraveau(Inserm), Lucie Vettoretti(Université d'Angers), Jean‐Michel Constantin(Université d'Angers), Gilles Capellier(Université d'Angers)
New England Journal of Medicine
March 11, 2020
Cited by 469Open Access
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Abstract

BACKGROUND: ) between 55 and 80 mm Hg. Prospective validation of this range in patients with ARDS is lacking. We hypothesized that targeting the lower limit of this range would improve outcomes in patients with ARDS. METHODS: , ≥96%) for 7 days. The same mechanical-ventilation strategies were used in both groups. The primary outcome was death from any cause at 28 days. RESULTS: After the enrollment of 205 patients, the trial was prematurely stopped by the data and safety monitoring board because of safety concerns and a low likelihood of a significant difference between the two groups in the primary outcome. Four patients who did not meet the eligibility criteria were excluded. At day 28, a total of 34 of 99 patients (34.3%) in the conservative-oxygen group and 27 of 102 patients (26.5%) in the liberal-oxygen group had died (difference, 7.8 percentage points; 95% confidence interval [CI], -4.8 to 20.6). At day 90, 44.4% of the patients in the conservative-oxygen group and 30.4% of the patients in the liberal-oxygen group had died (difference, 14.0 percentage points; 95% CI, 0.7 to 27.2). Five mesenteric ischemic events occurred in the conservative-oxygen group. CONCLUSIONS: ClinicalTrials.gov number, NCT02713451.).


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