Evidence map›Paper›PMID 25532567›Full record

SynthesisCritical care (London, England)2014

Arterial hyperoxia and mortality in critically ill patients: a systematic review and meta-analysis.

Elisa Damiani, Erica Adrario, Massimo Girardis, Rocco Romano, Paolo Pelaia, Mervyn Singer, Abele Donati

3 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 128 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
128citing papers in PubMed, 15 pooled it
–field-weighted citation impact
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.

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)
NCT06501118 narecruitingnot on this mapstarted 2024, after this paper: background citation

Optimizing Care in Critically Ill at UCHealth by Liberalizing the Target O2 in Mechanically-ventilated ICU Patients

TypeinterventionalSponsorUniversity of Colorado, DenverRan2024 to 2026Enrolled3,600ConditionsRespiratory Failure, Acute Hypoxemic Respiratory Failure, Acute Hypoxic Respiratory Failure, HypoxemiaArmsEducation, Epic notification alert
3 · Its place in the literature

Who cites it

128 citing papers in PubMed, 15 syntheses or guidelines pooled it.

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68 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Elisa DamianiAnaesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10, 60126, Torrette di Ancona, Italy. eli.dam86@alice.it.
Erica AdrarioAnaesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10, 60126, Torrette di Ancona, Italy. e.adrario@univpm.it.
Massimo GirardisDepartment of Anaesthesia and Intensive Care, University Hospital of Modena, Via del Pozzo 71, 41124, Modena, Italy. girardis.massimo@unimo.it.
Rocco RomanoAnaesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10, 60126, Torrette di Ancona, Italy. viboval@yahoo.it.
Paolo PelaiaAnaesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10, 60126, Torrette di Ancona, Italy. p.pelaia@univpm.it.
Mervyn SingerBloomsbury Institute of Intensive Care Medicine, University College London, Gower Street, London, WC1E 6BT, UK. m.singer@ucl.ac.uk.
Abele DonatiAnaesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10, 60126, Torrette di Ancona, Italy. a.donati@univpm.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe safety of arterial hyperoxia is under increasing scrutiny. We performed a systematic review of the literature to determine whether any association exists between arterial hyperoxia and mortality in critically ill patient subsets.

methodsMedline, Thomson Reuters Web of Science and Scopus databases were searched from inception to June 2014. Observational or interventional studies evaluating the relationship between hyperoxia (defined as a supranormal arterial O2 tension) and mortality in adult intensive care unit (ICU) patients were included. Studies primarily involving patients with exacerbations of chronic pulmonary disease, acute lung injury and perioperative administration were excluded. Adjusted odds ratio (OR) of patients exposed versus those not exposed to hyperoxia were extracted, if available. Alternatively, unadjusted outcome data were recorded. Data on patients, study characteristics and the criteria used for defining hyperoxia exposure were also extracted. Random-effects models were used for quantitative synthesis of the data, with a primary outcome of hospital mortality.

resultsIn total 17 studies (16 observational, 1 prospective before-after) were identified in different patient categories: mechanically ventilated ICU (number of studies (k) = 4, number of participants (n) = 189,143), post-cardiac arrest (k = 6, n = 19,144), stroke (k = 2, n = 5,537), and traumatic brain injury (k = 5, n = 7,488). Different criteria were used to define hyperoxia in terms of PaO2 value (first, highest, worst, mean), time of assessment and predetermined cutoffs. Data from studies on ICU patients were not pooled because of extreme heterogeneity (inconsistency (I(2)) 96.73%). Hyperoxia was associated with increased mortality in post-cardiac arrest patients (OR = 1.42 (1.04 to 1.92) I(2) 67.73%) stroke (OR = 1.23 (1.06 to 1.43) I(2) 0%) and traumatic brain injury (OR = 1.41 (1.03 to 1.94) I(2) 64.54%). However, these results are limited by significant heterogeneity between studies.

conclusionsHyperoxia may be associated with increased mortality in patients with stroke, traumatic brain injury and those resuscitated from cardiac arrest. However, these results are limited by the high heterogeneity of the included studies.

Indexed as

Arterial PressureBlood Gas AnalysisCritical IllnessHospital MortalityHumansHyperoxiaObservational Studies as TopicProspective Studies

Identifiers

PMID25532567
PMCPMC4298955

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.