Author:
L'Her Erwan,Dias Patricia,Gouillou Maelenn,Riou Anne,Souquiere Luc,Paleiron Nicolas,Archambault Patrick,Bouchard Pierre-Alexandre,Lellouche François
Abstract
Oxygen is commonly administered in hospitals, with poor adherence to treatment recommendations.We conducted a multicentre randomised controlled study in patients admitted to the emergency department requiring O2≥3 L·min−1. Patients were randomised to automated closed-loop or manual O2titration during 3 h. Patients were stratified according to arterial carbon dioxide tension (PaCO2) (hypoxaemicPaCO2≤45 mmHg; or hypercapnicPaCO2>45–≤55 mmHg) and study centre. Arterial oxygen saturation measured by pulse oximetry (SpO2) goals were 92–96% for hypoxaemic, or 88–92% for hypercapnic patients. Primary outcome was % time withinSpO2target. Secondary endpoints were hypoxaemia and hyperoxia prevalence, O2weaning, O2duration and hospital length of stay.187 patients were randomised (93 automated, 94 manual) and baseline characteristics were similar between the groups. Time within theSpO2target was higher under automated titration (81±21%versus51±30%, p<0.001). Time with hypoxaemia (3±9%versus5±12%, p=0.04) and hyperoxia under O2(4±9%versus22±30%, p<0.001) were lower with automated titration. O2could be weaned at the end of the study in 14.1%versus4.3% patients in the automated and manual titration group, respectively (p<0.001). O2duration during the hospital stay was significantly reduced (5.6±5.4versus7.1±6.3 days, p=0.002).Automated O2titration in the emergency department improved oxygenation parameters and adherence to guidelines, with potential clinical benefits.
Funder
The Ministry of Finance in Québec for Canadian centers
Programme Hospitalier de Recherche Clinique National 2010 from the French Ministry of Health for french centers
Publisher
European Respiratory Society (ERS)
Subject
Pulmonary and Respiratory Medicine
Cited by
48 articles.
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