tetano
Editor, Senior Moderator
Intensive Care Med
. 2024 Sep 5.
doi: 10.1007/s00134-024-07613-2. Online ahead of print. Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxaemia
Elena Crescioli[SUP] 1 2 [/SUP], Frederik Mølgaard Nielsen[SUP] 3 4 [/SUP], Anne-Marie Bunzel[SUP] 3 [/SUP], Anne Sofie Broberg Eriksen[SUP] 3 [/SUP], Martin Siegemund[SUP] 5 [/SUP], Lone Musaeus Poulsen[SUP] 6 [/SUP], Anne Sofie Andreasen[SUP] 7 [/SUP], Morten Heiberg Bestle[SUP] 8 9 [/SUP], Susanne Andi Iversen[SUP] 10 [/SUP], Anne Craveiro Brøchner[SUP] 11 [/SUP], Thorbjørn Grøfte[SUP] 12 [/SUP], Thomas Hildebrandt[SUP] 13 [/SUP], Jon Henrik Laake[SUP] 14 [/SUP], Maj-Brit Nørregaard Kjær[SUP] 15 [/SUP], Theis Lange[SUP] 16 [/SUP], Anders Perner[SUP] 9 15 [/SUP], Thomas Lass Klitgaard[SUP] 3 [/SUP], Olav Lilleholt Schjørring[SUP] 3 4 [/SUP], Bodil Steen Rasmussen[SUP] 3 4 [/SUP]
Affiliations
Purpose: The aim of this study was to evaluate one-year outcomes of lower versus higher oxygenation targets in intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19) and severe hypoxaemia.
Methods: We conducted pre-planned analyses of one-year mortality and health-related quality of life (HRQoL) in the Handling Oxygenation Targets in COVID-19 trial. The trial randomised 726 ICU patients with COVID-19 and hypoxaemia to partial pressure of arterial oxygen targets of 8 kPa (60 mmHg) versus 12 kPa (90 mmHg) during ICU stay up to 90 days, including readmissions. HRQoL was assessed using EuroQol visual analogue scale (EQ-VAS) and 5-level 5-dimension questionnaire (EQ-5D-5L). Outcomes were analysed in the intention-to-treat population. Non-survivors were assigned the worst possible score (zero), and multiple imputation was applied for missing EQ-VAS values.
Results: We obtained one-year vital status for 691/726 (95.2%) of patients and HRQoL data for 642/726 (88.4%). At one year, 117/348 (33.6%) of patients in the lower-oxygenation group had died compared to 134/343 (39.1%) in the higher-oxygenation group (adjusted risk ratio: 0.85; 98.6% confidence interval (CI) 0.66-1.09; p = 0.11). Median EQ-VAS was 50 (interquartile range, 0-80) versus 40 (0-75) (adjusted mean difference: 4.8; 98.6% CI - 2.2 to 11.9; p = 0.09) and EQ-5D-5L index values were 0.61 (0-0.81) in the lower-oxygenation group versus 0.43 (0-0.79) (p = 0.20) in the higher-oxygenation group, respectively.
Conclusion: Among adult ICU patients with COVID-19 and severe hypoxaemia, one-year mortality results were most compatible with benefit of the lower oxygenation target, which did not appear to result in more survivors with poor quality of life.
Keywords: COVID-19; Intensive care units; Mortality; Oxygen inhalation therapy; Quality of life.
. 2024 Sep 5.
doi: 10.1007/s00134-024-07613-2. Online ahead of print. Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxaemia
Elena Crescioli[SUP] 1 2 [/SUP], Frederik Mølgaard Nielsen[SUP] 3 4 [/SUP], Anne-Marie Bunzel[SUP] 3 [/SUP], Anne Sofie Broberg Eriksen[SUP] 3 [/SUP], Martin Siegemund[SUP] 5 [/SUP], Lone Musaeus Poulsen[SUP] 6 [/SUP], Anne Sofie Andreasen[SUP] 7 [/SUP], Morten Heiberg Bestle[SUP] 8 9 [/SUP], Susanne Andi Iversen[SUP] 10 [/SUP], Anne Craveiro Brøchner[SUP] 11 [/SUP], Thorbjørn Grøfte[SUP] 12 [/SUP], Thomas Hildebrandt[SUP] 13 [/SUP], Jon Henrik Laake[SUP] 14 [/SUP], Maj-Brit Nørregaard Kjær[SUP] 15 [/SUP], Theis Lange[SUP] 16 [/SUP], Anders Perner[SUP] 9 15 [/SUP], Thomas Lass Klitgaard[SUP] 3 [/SUP], Olav Lilleholt Schjørring[SUP] 3 4 [/SUP], Bodil Steen Rasmussen[SUP] 3 4 [/SUP]
Affiliations
- PMID: 39235624
- DOI: 10.1007/s00134-024-07613-2
Purpose: The aim of this study was to evaluate one-year outcomes of lower versus higher oxygenation targets in intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19) and severe hypoxaemia.
Methods: We conducted pre-planned analyses of one-year mortality and health-related quality of life (HRQoL) in the Handling Oxygenation Targets in COVID-19 trial. The trial randomised 726 ICU patients with COVID-19 and hypoxaemia to partial pressure of arterial oxygen targets of 8 kPa (60 mmHg) versus 12 kPa (90 mmHg) during ICU stay up to 90 days, including readmissions. HRQoL was assessed using EuroQol visual analogue scale (EQ-VAS) and 5-level 5-dimension questionnaire (EQ-5D-5L). Outcomes were analysed in the intention-to-treat population. Non-survivors were assigned the worst possible score (zero), and multiple imputation was applied for missing EQ-VAS values.
Results: We obtained one-year vital status for 691/726 (95.2%) of patients and HRQoL data for 642/726 (88.4%). At one year, 117/348 (33.6%) of patients in the lower-oxygenation group had died compared to 134/343 (39.1%) in the higher-oxygenation group (adjusted risk ratio: 0.85; 98.6% confidence interval (CI) 0.66-1.09; p = 0.11). Median EQ-VAS was 50 (interquartile range, 0-80) versus 40 (0-75) (adjusted mean difference: 4.8; 98.6% CI - 2.2 to 11.9; p = 0.09) and EQ-5D-5L index values were 0.61 (0-0.81) in the lower-oxygenation group versus 0.43 (0-0.79) (p = 0.20) in the higher-oxygenation group, respectively.
Conclusion: Among adult ICU patients with COVID-19 and severe hypoxaemia, one-year mortality results were most compatible with benefit of the lower oxygenation target, which did not appear to result in more survivors with poor quality of life.
Keywords: COVID-19; Intensive care units; Mortality; Oxygen inhalation therapy; Quality of life.