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Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Acta+Anaesthesiol+Scand 2022 ; 66 (1): 76-84 Nephropedia Template TP
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Oxygenation targets in ICU patients with COVID-19: A post hoc subgroup analysis of the HOT-ICU trial #MMPMID34425016
Rasmussen BS; Klitgaard TL; Perner A; Brand BA; Hildebrandt T; Siegemund M; Hollinger A; Aagaard SR; Bestle MH; Marcussen KV; Brochner AC; Solling CG; Poulsen LM; Laake JH; Aslam TN; Backlund M; Okkonen M; Morgan M; Sharman M; Lange T; Wetterslev J; Schjorring OL
Acta Anaesthesiol Scand 2022[Jan]; 66 (1): 76-84 PMID34425016show ga
BACKGROUND: Supplemental oxygen is the key intervention for severe and critical COVID-19 patients. With the unstable supplies of oxygen in many countries, it is important to define the lowest safe dosage. METHODS: In spring 2020, 110 COVID-19 patients were enrolled as part of the Handling Oxygenation Targets in the ICU trial (HOT-ICU). Patients were allocated within 12 h of ICU admission. Oxygen therapy was titrated to a partial pressure of arterial oxygen (PaO(2) ) of 8 kPa (lower oxygenation group) or a PaO(2) of 12 kPa (higher oxygenation group) during ICU stay up to 90 days. We report key outcomes at 90 days for the subgroup of COVID-19 patients. RESULTS: At 90 days, 22 of 54 patients (40.7%) in the lower oxygenation group and 23 of 55 patients (41.8%) in the higher oxygenation group had died (adjusted risk ratio: 0.87; 95% confidence interval, 0.58-1.32). The percentage of days alive without life support was significantly higher in the lower oxygenation group (p = 0.03). The numbers of severe ischemic events were low with no difference between the two groups. Proning and inhaled vasodilators were used more frequently, and the positive end-expiratory pressure was higher in the higher oxygenation group. Tests for interactions with the results of the remaining HOT-ICU population were insignificant. CONCLUSIONS: Targeting a PaO(2) of 8 kPa may be beneficial in ICU patients with COVID-19. These results come with uncertainty due to the low number of patients in this unplanned subgroup analysis, and insignificant tests for interaction with the main HOT-ICU trial. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov number, NCT03174002. Date of registration: June 2, 2017.