Ontology type: schema:ScholarlyArticle Open Access: True
2013-08
AUTHORSRahul Raj, Stepani Bendel, Matti Reinikainen, Riku Kivisaari, Jari Siironen, Maarit Lång, Markus Skrifvars
ABSTRACTINTRODUCTION: The relationship between hyperoxemia and outcome in patients with traumatic brain injury (TBI) is controversial. We sought to investigate the independent relationship between hyperoxemia and long-term mortality in patients with moderate-to-severe traumatic brain injury. METHODS: The Finnish Intensive Care Consortium database was screened for mechanically ventilated patients with a moderate-to-severe TBI. Patients were categorized, according to the highest measured alveolar-arterial O₂ gradient or the lowest measured PaO₂ value during the first 24 hours of ICU admission, to hypoxemia (<10.0 kPa), normoxemia (10.0 to 13.3 kPa) and hyperoxemia (>13.3 kPa). We adjusted for markers of illness severity to evaluate the independent relationship between hyperoxemia and 6-month mortality. RESULTS: A total of 1,116 patients were included in the study, of which 16% (n = 174) were hypoxemic, 51% (n = 567) normoxemic and 33% (n = 375) hyperoxemic. The total 6-month mortality was 39% (n = 435). A significant association between hyperoxemia and a decreased risk of mortality was found in univariate analysis (P = 0.012). However, after adjusting for markers of illness severity in a multivariate logistic regression model hyperoxemia showed no independent relationship with 6-month mortality (hyperoxemia vs. normoxemia OR 0.88, 95% CI 0. 63 to 1.22, P = 0.43; hyperoxemia vs. hypoxemia OR 0.97, 95% CI 0.63 to 1.50, P = 0.90). CONCLUSION: Hyperoxemia in the first 24 hours of ICU admission after a moderate-to-severe TBI is not predictive of 6-month mortality. More... »
PAGESr177
http://scigraph.springernature.com/pub.10.1186/cc12856
DOIhttp://dx.doi.org/10.1186/cc12856
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PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/23958227
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"description": "INTRODUCTION: The relationship between hyperoxemia and outcome in patients with traumatic brain injury (TBI) is controversial. We sought to investigate the independent relationship between hyperoxemia and long-term mortality in patients with moderate-to-severe traumatic brain injury.\nMETHODS: The Finnish Intensive Care Consortium database was screened for mechanically ventilated patients with a moderate-to-severe TBI. Patients were categorized, according to the highest measured alveolar-arterial O\u2082 gradient or the lowest measured PaO\u2082 value during the first 24 hours of ICU admission, to hypoxemia (<10.0 kPa), normoxemia (10.0 to 13.3 kPa) and hyperoxemia (>13.3 kPa). We adjusted for markers of illness severity to evaluate the independent relationship between hyperoxemia and 6-month mortality.\nRESULTS: A total of 1,116 patients were included in the study, of which 16% (n\u2009=\u2009174) were hypoxemic, 51% (n\u2009=\u2009567) normoxemic and 33% (n\u2009=\u2009375) hyperoxemic. The total 6-month mortality was 39% (n\u2009=\u2009435). A significant association between hyperoxemia and a decreased risk of mortality was found in univariate analysis (P\u2009=\u20090.012). However, after adjusting for markers of illness severity in a multivariate logistic regression model hyperoxemia showed no independent relationship with 6-month mortality (hyperoxemia vs. normoxemia OR 0.88, 95% CI 0. 63 to 1.22, P\u2009=\u20090.43; hyperoxemia vs. hypoxemia OR 0.97, 95% CI 0.63 to 1.50, P\u2009=\u20090.90).\nCONCLUSION: Hyperoxemia in the first 24 hours of ICU admission after a moderate-to-severe TBI is not predictive of 6-month mortality.",
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