Evidence map›Paper›PMID 20959284›Full record

Trial reportBMJ (Clinical research ed.)2010

Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial.

Michael A Austin, Karen E Wills, Leigh Blizzard, Eugene H Walters, Richard Wood-Baker

4 registry-linked trialsOpen access · hybridAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 153 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
153citing papers in PubMed, 9 pooled it
20.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02666937 completednot on this mapstarted 2015, after this paper: background citation

Safe Limits in Saturation (SLIM-study)

TypeobservationalSponsorAmsterdam UMC, location VUmcRan2015 to 2017Enrolled879ConditionsCritical Illness, Hyperoxia, Hypoxia
NCT03696563 naunknown statusnot on this mapstarted 2021, after this paper: background citation

Automated Administration of Oxygen Using the FreeO2 Device in Ambulances for COPD and Trauma Patients: A Feasibility Study

TypeinterventionalSponsorFrançois LelloucheRan2021 to 2022Enrolled100ConditionsCOPD Exacerbation, TraumaArmsAutomated oxygen administration - FreeO2, Standard administration of oxygen flow
NCT04534959 phase3active not recruitingnot on this mapstarted 2020, after this paper: background citation

Strategy to Avoid Excessive Oxygen for Critically Ill Trauma Patients (SAVE-O2)

TypeinterventionalSponsorUniversity of Colorado, DenverRan2020 to 2025Enrolled6,000ConditionsCritical Illness, Wounds and Injury, Disease Attributes, Pathologic ProcessesArmsTargeting Normoxemia (SpO2 90-96%, PaO2 60-100 mmHg)
NCT04534972 phase3active not recruitingnot on this mapstarted 2021, after this paper: background citation

Strategy to Avoid Excessive Oxygen in Major Burn Patients (SAVE-O2)

TypeinterventionalSponsorUniversity of Colorado, DenverRan2021 to 2025Enrolled2,000ConditionsCritical Illness, Wounds and Injury, Disease Attributes, Pathologic ProcessesArmsTargeting Normoxemia (SpO2 90-96%, PaO2 60-100 mmHg)
3 · Its place in the literature

Who cites it

153 citing papers in PubMed, 9 syntheses or guidelines pooled it, 500 citations in OpenAlex.

  1. Manual compared to automated closed-loop oxygen control strategies in hospitalised adults: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2026
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  3. [Oxygen in the acute care of adults : Short version of the German S3 guideline].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2022
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  14. The effect of 50% oxygen on PtCOBMC pulmonary medicine · 2020
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93 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Michael A AustinMenzies Research Institute, University of Tasmania, Hobart, Tasmania, 7001 Australia. maaustin@utas.edu.au
Karen E Wills
Leigh Blizzard
Eugene H Walters
Richard Wood-Baker
University of Tasmania · AURoyal Hobart Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare standard high flow oxygen treatment with titrated oxygen treatment for patients with an acute exacerbation of chronic obstructive pulmonary disease in the prehospital setting.

designCluster randomised controlled parallel group trial.

settingAmbulance service in Hobart, Tasmania, Australia.

participants405 patients with a presumed acute exacerbation of chronic obstructive pulmonary disease who were treated by paramedics, transported, and admitted to the Royal Hobart Hospital during the trial period; 214 had a diagnosis of chronic obstructive pulmonary disease confirmed by lung function tests in the previous five years.

interventionsHigh flow oxygen treatment compared with titrated oxygen treatment in the prehospital (ambulance/paramedic) setting.

main outcome measurePrehospital or in-hospital mortality.

resultsIn an intention to treat analysis, the risk of death was significantly lower in the titrated oxygen arm compared with the high flow oxygen arm for all patients (high flow oxygen n=226; titrated oxygen n=179) and for the subgroup of patients with confirmed chronic obstructive pulmonary disease (high flow n=117; titrated n=97). Overall mortality was 9% (21 deaths) in the high flow oxygen arm compared with 4% (7 deaths) in the titrated oxygen arm; mortality in the subgroup with confirmed chronic obstructive pulmonary disease was 9% (11 deaths) in the high flow arm compared with 2% (2 deaths) in the titrated oxygen arm. Titrated oxygen treatment reduced mortality compared with high flow oxygen by 58% for all patients (relative risk 0.42, 95% confidence interval 0.20 to 0.89; P=0.02) and by 78% for the patients with confirmed chronic obstructive pulmonary disease (0.22, 0.05 to 0.91; P=0.04). Patients with chronic obstructive pulmonary disease who received titrated oxygen according to the protocol were significantly less likely to have respiratory acidosis (mean difference in pH 0.12 (SE 0.05); P=0.01; n=28) or hypercapnia (mean difference in arterial carbon dioxide pressure -33.6 (16.3) mm Hg; P=0.02; n=29) than were patients who received high flow oxygen.

conclusionsTitrated oxygen treatment significantly reduced mortality, hypercapnia, and respiratory acidosis compared with high flow oxygen in acute exacerbations of chronic obstructive pulmonary disease. These results provide strong evidence to recommend the routine use of titrated oxygen treatment in patients with breathlessness and a history or clinical likelihood of chronic obstructive pulmonary disease in the prehospital setting.

trial registrationAustralian New Zealand Clinical Trials Register ACTRN12609000236291.

Indexed as

AdultAgedCluster AnalysisEmergency Medical ServicesFemaleHumansLength of StayMaleMiddle AgedOxygenPulmonary Disease, Chronic ObstructiveRural HealthTasmaniaUrban HealthOxygen

Identifiers

PMID20959284
PMCPMC2957540
OpenAlexW1975803576

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.