Reducing supplementary oxygen given to intensive care patients does not deliver any clear and obvious health benefits or harm their chances of survival, according to new research.
Each year, around 184,000 patients are admitted to NHS intensive care units (ICUs) and over 30% need breathing support in the form of oxygen provided through mechanical ventilators.
However, there is insufficient evidence to guide the use of oxygen, with the possibility that administering too much, or too little, oxygen may not deliver the intended benefits and actually end up causing patients additional harm.
That prompted researchers to establish UK-ROX, the largest ever clinical trial of oxygen use in UK ICUs, and they recruited 16,500 patients across almost 100 intensive care units at UK hospitals.
They then sought to establish whether a strategy of conservative oxygen therapy – delivering less oxygen to maintain a person’s oxygen saturation at around 90% – would reduce mortality rates among ICU patients.
The results – published in the JAMA journal – showed there was no statistically significant difference in patient outcomes with 35.4% of patients receiving conservative oxygen therapy having died within 90 days of their admission compared with 34.9% of patients receiving usual oxygen therapy.
As a result, they believe it is safe to allow oxygen levels to be lower in ICU patients but that it may not necessarily be better for them in terms of survival, with the need to develop and evaluate more personalised therapies based on a person’s specific medical conditions.
The UK-ROX trial, funded by the National Institute for Health and Care Research (NIHR), was led by researchers at the University of Plymouth’s
Peninsula Medical School
and the Intensive Care National Audit & Research Centre (ICNARC)
Professor Daniel Martin
