Conservative Oxygen Therapy in Mechanically Ventilated Critically Ill Adult Patients

作者：Daniel Martín, Doug W Gould, Tasnin Shahid, James Doidge, Alex Cowden, Zia Sadique, Julie Camsooksai, Walton N. Charles, Miriam Davey, Amelia Francis-Johnson, Roger M. Garrett, Michael P. W. Grocott, Joanne Jones, Lamprini Lampro, Diane Mackle, B. Ronan O’Driscoll, Alvin Richards‐Belle, Anthony Rostron, Tamás Szakmány, Alex Warren, Paul J. Young, Kathy Rowan, David A Harrison, Paul Mouncey, UK-ROX Investigators, Sheena Quaid, Iru Pyakurel, P G Gopi, Mike Dean, Mustafa Serri, Valli Ratnam, S. Herath, Jill Kirk, Mandy Gill, Anil Hormis, Cheryl Graham, Jake Warrington, George Hamson, Jake McCormick, Tabassum Khan, Michael Dean, Liby Biju, Lakshmi Aneesh, Emily Case, Sashika Selladurai, Oliver Hamilton, Laurence Allan, Alexandra Wright, Eleanor Houghton, Isabel González, Jessica Jones, Amy D. Thompson, A. Kimberley McAllister, Jessica Coulman, Sue Jackson, Karen Salmon, Sara Navalesi, Missy Harrison, Ahilanandan Dushianthan, Anthony Rostron, Sarah Cornell, Lindsey Woods, Josephine Boxall, David M. Smith, Louise Anderson, Ashely Lynass, Sophie Patterson, Jennie Rutter, Suzanne Holyoak, Rory McLagan, Katie Burke, John A. Thompson, A Holden, Thomas Billyard, Carl Hawkins, Geraldine Ward, Anna Ogorek, Margaret Lindsay, Tahir Saeed, Camilla Stagg, Penny Parsons, Bridget Campbell, Christopher Westall, Caroline S. Fox, Stacey Cotterell, Mable Anu, Ooi Huah Chiang, Roxanne Gray, Sarah Penkett, Muthukumaran Gourishankar, Paul Gill, Stephen Hutchinson, Manu Naik, Georgina Randell, Deirdre Fottrell-Gould, Helen Bell, Nicholas Truman, Matthew Smith, Qasim Ahmed, Victoria Cunliffe, Aayesha Kazi, I Clement', Leigh Dunn, Pamela Garcia, Luzgie Gavina, Susan Taylor, Mark Richards, Lauren Lodge, Arti Gulati, Nazrudeen Ali, Christopher King, Feroz Mohammad, I. Nasr, D. W. H. DURRANT, P. C. Taylor Dickinson, Tania Neale, Janine Armstrong, James E Stevenson, Ben Chandler, Marcela P. Vizcaychipi, Sanjeet Chana, Laura Bisinotto Martins, Ilhan Wardhere, Emily Futter, Julie Logan, Richard Innes, Richard D J Bufton, Andrew Gratrix, Elizabeth Stones, Matthew Hines, Karen Winter, Victoria Martinson, Dhinesh Sundaran, Laszlo Hollos, Anna Williams, Josef Enojo, Andrew Achilleos, Micheal Peter Jennings, Rosie Reece-Anthony, Alfa Cresia Nilo, Jayson Clarke, Mandeep Phull, Nauman Hussain, Tatiana Pogreban, Aparna George, Mykola Korol, Andrew Claxton, Chinelo H Ogbeide, Zoë Thomas, Denise McSorland, Barbara J. Philips, Laura Ortiz-Ruiz de Gordoa, Alex Harrison, Denise Skinner, Monika Gill, Benjamin Grodzinski, Chloé Monnier, Igor Otahal, Samantha Coetzee, Becky Icke, Jill Williams, Bethan Morse Browning, Ingeborg Welters, Arra Mahiya, Maria Lopez Martinez, Owain Greaves, Netanya Canagarajah, Henrik Reschreiter, Yasmin DeAth, Emma Langridge, Julie Camsooksai, Alex Mattin, Geraldine Hambrook, Alexandra Edwards, Silvia Sbardella, Abdullah Alkhudhayri, Redmond Tully, Michelle Mulcahy, Joy Dearden, Angiy Michael, Carrole Blessen, Brendan Sloan, Jennifer Rothwell, Sarah Buckley, Manoj Wickramasinghe, Rasmus Knudsen, Ceri Battle, Luke Newey, Hannah Toghill, Marie Williams, Caroline Davies, Tim Fudge, Tom Curtis, Dominic Kay, Daniel Horner, Jessica Pendlebury, Thomas Collyer, Lorraine Stephenson, James Featherstone, Tracy Burdett, Rob Charnock, Denise McFarland, Orla McAtasney, Emma McGregor, Paul Diamond, Alain Vuylsteke, Hema C. Nair, Mohamed Ben M'Barek, Pragya Sachan, H Brzezicki, Monica Popescu, Mary Mikhael, Anilkumar Thipparampall, Amrinder Sayan, James Gonzales, Julian Lentaigne, Bethan Stowe, Kayleigh Spencer, Cianne Brigdland, Liana Stapleton, Jonathan Hulme, Eleanor Higgs, Anne Hayes, Janine Lonsdale, Merin Lukose, Jodie Parry, Alicia Parker, Ellie Patel, Kristina Diridis, Kieran Donnelly, Tamás Szakmány, Abigail Waters, Shiney Cherian, Robert Jesty, C Spiers, Daniel Harvey, David A. Ford, Sophie Lubbock, Anju Thomas, Alice Baddeley, Alistair Morris, M. Richardson, Eleanor Meakin, Sansha Jane Harris, Kathryn Jane Birchall, Holly Caborn, William A Roberts-Margett, David Pogson, Helen Claridge, Monika Thwaites, S George, Emma Cox, Jade Beeston, Simone Carbert, Bethan Hutchinson, Clare Hutton, Mike Margarson, Yolanda Baird, Erikka Siddall, Sharon Floyd, Phil McGlone, Tom Lawton, Sharwend Supermanian, Jonathan Robinson, Simone Walsh, Sara B. Scott, Kay Protheroe, Jenny Ritzema, Tim Bonham, Rachel Lucas, Mark Pulletz, Andrew S. Ball, Ashleigh Cave, Trish Williams, Sarah Horton, Chris Murray, Padraig Headley, John McCaffrey, Samantha Hagan, Victoria Adell, David B.K. Golden, Miriam Davey, Rebecca Seaman, Laura K. Kent, M. E. Kelly, Amy Ackerley, Ilona Cassar, Fábio Fernandes, Christopher F Whitehead, Ged Smith, Clare Fletcher, David Whitmore, Jonathan Broad, Catriona Colwell, Maria Faulkner, Alison Ivison, Michael Spivey, Sarah Bean, Karen Burt, Rachel Chapman, Michael Reay, Angela Watts, Eleanor Traverse, Karen Reid, Tracy Edwards, P. A. Young, Mark Blunt, Aricsa Mariya Joshy, Mariam Rajani, N V Dawson, Veronica Pristopan, Ben Creagh-Brown, Jerik Verula, Neil Coulson, Magenta Black, Jenny Jones, Christine Alexander, Katie Sweet, Linda Pipira, Matthew Thomas, Kim Wright, Estefania Treus, Dumindu Karangoda, Georgina Luck, Shilpa Gurung, Glykeria Pakou, Mark De Neef, Amitaa Maharajh, Catarina Veiga, Sara Mingo Garcia, Richard Pugh, Joriling Collins, Jamie Scriven, Esther Garrod, Jenny Davies, Pavol Palcovic, Beata Misztal, Sandra Sowah, Suzanne T. Williams, Hayley Dolan, Maneka Braganza, Claire Hirst, Rheanna Oades, Emma Moakes, Christopher Hebbes, Rebecca Ealand, Steven G. Ellis, Prematie Andreou, Lidia I A Ramos, Lucy Howie, Gabrielle Evans, Mark T. Shiels, Jerry P. Nolan, Elizabeth Wilby, Michael Adlam, Susan Trott, Sheila Salada, Zoe Friar, Richard Gould, Sarah Watts, John Fletcher, Richard Faulkner, Terri Stabeler, Nigel Chee, Heather Tiller, Sally Pitts, Lukas Balcarek, Gareth Hardy, Amritapreeti Mukhopadhyay, Leonie Benham, Lisa Elawamy, Moustafa Shebl Zahra, Mozaffer Khan, Emily Sinfield, Charlotte Greenwood, Tracy Hazelton, C Vimalanathan, Mir Farooq, James A. Rand, Sarah Stirrup, Lucy Cooper, Alexander Midgley-Hunt, Megan E. O’Connell, Luke Simonds, Elitsa Mileva, Karen Austin, Olivia Kelsall, Jessica Thrush, Stephanie Chamberlain, Hannah Davies, Nicholas Cowley, Amro Katary, Louise Wilcox, Sunita Gurung, Murtaza Asif Ali, Precious Basvi, Luke Hodgson, Clinton Corin, Emma Sexton, Raquel Gomez-Marcos, Heather Fox, Nicholas Coleman, Minnie Gellamucho, Michelle Davies, Shanshank Danndhiganaahalli, Kelechi Okeagu, Selver Kalchko-Veyssal, Bridgett Masunda, Raji Orath Prabakaran, Prisca Gondo, Adam Revill, Pauline Joyce Aspa, Kelly M. Schiabor Barrett, Samuel Wenham, Ben Whittaker, Thaventhran Prabhahar, Kapil Jain, Dhanalakshmi Bakthavatsalam, MO Ibadin, Madhu Balasuubramaniam, Danielle Hollick, Emma McKenna, Rebecca Flanagan, Gareth Hughes, Adrain Donnelly, Jenny Cosgrove, Sinéad O’Kane, Ryan Campbell, Rohit Saha, Anna Broderick, Maria Axalan, Phillip Hopkins, Tom Williams, Miao Li Chee, Kevin O' Reilly, Burt Vergara, Gemma Baldwin, Teresa Tarling, Nick Vallotton, R. Orme, N Dodds, D Lonsdale, Susannah Leaver, Sarah Farnell-Ward, Deborah Dawson, Nikki Yun, Maria Thanasi, Shreeja Dangol, Massimiliano Valcher, Angelo Rocha, Milafe Nimer, Frenita Dsouza, Rebecca Kanu, Maria Maiz Cordoba, Vincent Ventura, Edna Fernandes, K.E. Lloyd, Christine Sicat, Pamela Kabungo, Vasiliki Kalogianni, Katherine Godfrey, Abdalla Kaware, Daniel Yiu, John M F Adam, Mohamed Ramali, George R. Harvey, Ryan Perry, Eduardo Caetano, Peter J Featherstone, Petra Polgarova, Cristina Bravo Elvira, Elena Roy, Jocelyn R. Marshall, Tim Furniss, Bijoy Mathew, Andrea Berry, R.E. Lauder, Ascanio Tridente, Karen Shuker, Robert Moynihan, Abdullah Motam, Mohamed Elhadi, Gail Priestley, J. W. S. Carter, Zoë Scott, H. Ballentine Carter, Thomas A. Clark, Andrew Pitt, Adam Smith, Kizzy Baines, Jacqueline Massey, Matt Thomas, Deanna Stephens, Rebecca Pope, Borislava Borislavova, Ruth Cookson, John Harris, Sara Smutts, Lisa Jobes, Rachel Hughes · 发表于：JAMA · 年份：2025 · DOI：10.1001/jama.2025.9663 · 被引用次数：37 · 研究领域：Respiratory Support and Mechanisms、Sepsis Diagnosis and Treatment、Nosocomial Infections in ICU

Importance: Supplemental oxygen is frequently given to patients in intensive care units (ICUs); however, there is insufficient evidence to guide its therapeutic use and to minimize the potential harm caused by administering too little or too much. Objective: To determine whether reducing exposure to supplemental oxygen through a strategy of conservative oxygen therapy by using a peripheral oxygen saturation (Spo2) target of 90% (range, 88%-92%) reduces mortality at 90 days in mechanically ventilated adult patients receiving supplemental oxygen in the ICU. Design, Setting, and Participants: Multicenter, pragmatic, randomized clinical trial conducted in 97 ICUs in the UK including 16 500 mechanically ventilated patients receiving supplemental oxygen. Participants were enrolled between May 2021 and November 2024. Follow-up was completed in February 2025. Interventions: Participants randomized to conservative oxygen therapy (n = 8258) received the lowest fraction of inspired oxygen possible to maintain their Spo2 at 90%. Participants randomized to usual oxygen therapy (n = 8242) received oxygen therapy at the discretion of the treating clinician. Main Outcomes and Measures: The primary outcome was all-cause mortality at 90 days. Secondary outcomes included duration of ICU and acute hospital stay among survivors, days alive and free from organ support at 30 days, and mortality at other time points. Results: Of 16 500 randomized patients, primary outcome data were available for 16 ...