{"id":24823,"date":"2023-12-21T04:07:00","date_gmt":"2023-12-20T20:07:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24823"},"modified":"2023-12-21T05:14:44","modified_gmt":"2023-12-20T21:14:44","slug":"blue-journal%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9aicu%e6%82%a3%e8%80%85%e7%9a%84%e4%bf%9d%e5%ae%88%e4%b8%8e%e8%87%aa%e7%94%b1%e6%b0%a7%e5%90%88%e7%9b%ae%e6%a0%87","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24823","title":{"rendered":"[Blue Journal\u53d1\u8868\u8bba\u6587]\uff1aICU\u60a3\u8005\u7684\u4fdd\u5b88\u4e0e\u81ea\u7531\u6c27\u5408\u76ee\u6807"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">Conservative versus Liberal Oxygenation Targets in Intensive Care Unit Patients (ICONIC): A Randomized Clinical Trial<\/h1>\n\n\n\n<h4 class=\"wp-block-heading\"><a href=\"https:\/\/orcid.org\/0000-0002-7350-0482\"><\/a>L. Imeen van der Wal,\u00a0\u00a0<a href=\"https:\/\/orcid.org\/0000-0002-1662-7751\"><\/a>Chloe C. A. Grim,\u00a0\u00a0Michael R. del Prado, et al<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\">Am J Respir Crit Care Med 2023; 208: 770-779<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\">Abstract<\/h4>\n\n\n\n<p><strong>Rationale:<\/strong>&nbsp;Supplemental oxygen is widely administered to ICU patients, but appropriate oxygenation targets remain unclear.<\/p>\n\n\n\n<p><strong>Objectives:<\/strong>&nbsp;This study aimed to determine whether a low-oxygenation strategy would lower 28-day mortality compared with a high-oxygenation strategy.<\/p>\n\n\n\n<p><strong>Methods:<\/strong>&nbsp;This randomized multicenter trial included mechanically ventilated ICU patients with an expected ventilation duration of at least 24\u2009hours. Patients were randomized 1:1 to a low-oxygenation (Pa<sub>O2<\/sub>, 55\u201380\u2009mm\u2009Hg; or oxygen saturation as measured by pulse oximetry, 91\u201394%) or high-oxygenation (Pa<sub>O2<\/sub>, 110\u2013150\u2009mm\u2009Hg; or oxygen saturation as measured by pulse oximetry, 96\u2013100%) target until ICU discharge or 28\u2009days after randomization, whichever came first. The primary outcome was 28-day mortality. The study was stopped prematurely because of the COVID-19 pandemic when 664 of the planned 1,512 patients were included.<\/p>\n\n\n\n<p><strong>Measurements and Main Results:<\/strong>\u00a0Between November 2018 and November 2021, a total of 664 patients were included in the trial: 335 in the low-oxygenation group and 329 in the high-oxygenation group. The median achieved Pa<sub>O2<\/sub>\u00a0was 75\u2009mm\u2009Hg (interquartile range, 70\u201384) and 115\u2009mm\u2009Hg (interquartile range, 100\u2013129) in the low- and high-oxygenation groups, respectively. At Day 28, 129 (38.5%) and 114 (34.7%) patients had died in the low- and high-oxygenation groups, respectively (risk ratio, 1.11; 95% confidence interval, 0.9\u20131.4;\u00a0<em>P<\/em>\u2009=\u20090.30). At least one serious adverse event was reported in 12 (3.6%) and 17 (5.2%) patients in the low- and high-oxygenation groups, respectively.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.atsjournals.org\/na101\/home\/literatum\/publisher\/thoracic\/journals\/content\/ajrccm\/2023\/ajrccm.2023.208.issue-7\/rccm.202303-0560oc\/20230921\/images\/large\/rccm.202303-0560ocf1.jpeg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.atsjournals.org\/na101\/home\/literatum\/publisher\/thoracic\/journals\/content\/ajrccm\/2023\/ajrccm.2023.208.issue-7\/rccm.202303-0560oc\/20230921\/images\/large\/rccm.202303-0560ocf2.jpeg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.atsjournals.org\/na101\/home\/literatum\/publisher\/thoracic\/journals\/content\/ajrccm\/2023\/ajrccm.2023.208.issue-7\/rccm.202303-0560oc\/20230921\/images\/large\/rccm.202303-0560ocf3.jpeg\" alt=\"\"\/><\/figure>\n\n\n\n<p><strong>Conclusions:<\/strong>&nbsp;Among mechanically ventilated ICU patients with an expected mechanical ventilation duration of at least 24\u2009hours, using a low-oxygenation strategy did not result in a reduction of 28-day mortality compared with a high-oxygenation strategy.<\/p>\n\n\n\n<p>Clinical trial registered with the National Trial Register and the International Clinical Trials Registry Platform (NTR7376).<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Conservative versus Liberal Oxygenation Targets in Inte [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24823"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24823"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24823\/revisions"}],"predecessor-version":[{"id":24824,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24823\/revisions\/24824"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24823"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24823"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24823"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}