Table 2.
Randomized Trials of Conservative vs. Liberal Oxygen Targets in Critically Ill Patients
| Study | Population | Sample Size | Target (Conservative vs. Liberal) | Primary Outcome | Results (Conservative vs. Liberal) |
|---|---|---|---|---|---|
| Panwar et al. (2016) (61) | Adult ICU patients requiring IMV | 103 | SpO2 of 88–92% vs. ⩾96% | Mean AUC for SpO2, SaO2, PaO2, and FiO2 | Feasibility study; good separation in study groups; no adverse safety signals |
| Girardis et al. (2016) (62): OX-ICU | Adult ICU admission for >72 h anticipated (IMV and no IMV) | 434 | PaO2 of 70–100 mm Hg (SpO2 of 94– 98%) vs. PaO2 of up to 150 mm Hg and SpO2 of 97–100% | ICU mortality | Decreased mortality; ARR, 8.6% (95% CI, 1.7–15.0%) |
| Mackle et al. (2020) (64): ICU-ROX | Adult ICU patients on IMV | 1,000 | SpO2 >90% with alarm set at 97%, “usual-care group”; no upper-limit alarm (FiO2 of <0.3 discouraged) | VFD | No differences in VFD or 90- or 180-d mortality |
| Barrot et al. (2020) (63): LOCO2 | Adult ARDS patients on IMV | 205 | PaO2 of 55–70 mm Hg/SpO2 of 88–92% vs. PaO2 of 90–105 mm Hg/SpO2 of >96% for first 7 d of MV | 28-d mortality | No difference in 28-d mortality; higher 90-d mortality (absolute risk increase of 7.8% [95% CI, 0.7–27.2%]). Trial stopped early for five events of mesenteric ischemia in conservative arm |
| Schjørring et al. (2021) (65): HOT-ICU | Adults with acute hypoxemic respiratory failure (FiO2 ⩾0.5 on IMV or O2 ⩾10 L/min in open system) | 2,928 | PaO2 of 60 mm Hg vs. PaO2 of 90 mm Hg | 90-d mortality | No difference in 90-d mortality or other secondary outcomes; no difference in serious adverse events |
Definition of abbreviations: ARDS = acute respiratory distress syndrome; ARR = absolute risk reduction; AUC = area under the curve; CI = confidence interval; HOT-ICU = Handling Oxygen Targets in the ICU; ICU-ROX = ICU Randomized Trial Comparing Two Approaches to Oxygen Therapy; IMV = invasive MV; LOCO2 = Liberal Oxygenation versus Conservative Oxygenation in ARDS; MV = mechanical ventilation; OX-ICU = Oxygen–ICU; RCT = randomized controlled trial; SpO2 = oxygen saturation as measured by pulse oximetry; TBI = traumatic brain injury; VFD = ventilator-free days.
Note this table does not include RCTs of patients with cardiac arrest, TBI, or stroke.