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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2024

Open Access 01-12-2024 | Review

Conservative versus liberal oxygen therapy for intensive care unit patients: meta-analysis of randomized controlled trials

Authors: Xin-yu Li, Bing Dai, Hai-jia Hou, Hong-wen Zhao, Wei Wang, Jian Kang, Wei Tan

Published in: Annals of Intensive Care | Issue 1/2024

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Abstract

Background

It remains unclear whether conservative oxygen therapy (COT) or liberal oxygen therapy (LOT) is more beneficial to the clinical outcomes of intensive care unit (ICU) patients. We systematically reviewed the efficacy and safety of conservative versus liberal oxygen therapy for ICU patients.

Methods

We systematically searched PubMed, Embase, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, MedRxiv, and BioRxiv for reports on randomized controlled trials (RCTs) that compared the effects of COT versus LOT on the clinical outcomes of ICU patients published in English before April 2024. The primary outcome was the mortality rate, secondary outcomes included ICU and hospital length of stay, days free from mechanical ventilation support (MVF), vasopressor-free time (VFT), and adverse events.

Results

In all, 13 RCTs involving 10,632 patients were included in analyses. Meta-analysis showed COT did not reduce mortality at 30-day (risk ratio [RR] = 1.01, 95% confidence interval [CI] 0.94 to 1.09, I2 = 42%, P = 0.78), 90-day (RR = 1.01, 95% CI 0.95 to 1.08, I2 = 9%, P = 0.69), or longest follow-up (RR = 1.00, 95% CI 0.95 to 1.06, I2 = 22%, P = 0.95) compared to LOT in ICU patients. In subgroup analyses, no significant difference was observed between the two groups in terms of the different ICU, baseline P/F, and actual PaO2. In addition, COT did not affect ICU length of stay, hospital length of stay, or VFT, it only affected MVF days.

Conclusions

COT did not reduce all-cause mortality in ICU patients. Further RCTs are urgently needed to confirm the impact of COT strategy on specific populations.
Appendix
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Metadata
Title
Conservative versus liberal oxygen therapy for intensive care unit patients: meta-analysis of randomized controlled trials
Authors
Xin-yu Li
Bing Dai
Hai-jia Hou
Hong-wen Zhao
Wei Wang
Jian Kang
Wei Tan
Publication date
01-12-2024
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2024
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-024-01300-7

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