Oxygen supplementation at higher levels for critically ill patients: uncertain effects but may increase mortality and adverse effects
Citation: Barbateskovic M, Schjørring OL, Russo Krauss S, Jakobsen JC, Meyhoff CS, Dahl RM, Rasmussen BS, Perner A, Wetterslev J. Higher versus lower fraction of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit. Cochrane Database of Systematic Reviews 2019; (11): CD012631.
What is this? Some patients with COVID-19 will become critically ill and need help with their breathing. They may be given extra oxygen to breathe, which might be provided by mechanical ventilation (MV) in an intensive care unit (ICU). Clinicians need to decide on the amount of supplemental oxygen to use.
In this Cochrane systematic review, the authors searched for randomized trials of the effects of different levels of supplemental oxygen in adult ICU patients. They did not restrict by date, type or language of publication and did their searches in December 2018. They identified 10 studies (1458 participants). All the studies compared more with less oxygen, but using very different levels of oxygen supplementation.
What works: Nothing noted.
What doesn’t work: Nothing noted.
What’s uncertain: The effects of higher levels of oxygen are uncertain, but higher levels may increase mortality and adverse effects.