An observational cohort study of three large tertiary care ICUs in the Netherlands evaluated previously used and newly constructed metrics of arterial hyperoxia and systematically assessed their association with clinical outcomes in different subgroups in the ICU. Arterial blood gas analyses and concurrent ventilator settings were extracted from MetaVision. The authors found that metrics of central tendency for severe arterial hyperoxia, as well as exposure time for mild and severe arterial hyperoxia, were associated with unfavorable outcomes of ICU patients both within and beyond the first day of admission. Their results suggest that the relationship was consistent for large patient groups and that previously used approaches may not have completely captured the actual exposure effects. The authors conclude that “we should limit the PaO2 levels of critically ill patients within a safe range, as we do with other physiologic variables. Analytical metrics of arterial hyperoxia should be judiciously considered when interpreting and comparing study results and future studies are needed to validate our findings in a randomized fashion design.”
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