Conservative <em>versus</em> conventional oxygen therapy in type I acute respiratory failure patients in respiratory intensive care unit, Zagazig University

Abstract

The present study aimed to assess the effect of conservative (permissive hypoxaemia) versus conventional (normoxaemia) protocol for oxygen supplementation on outcome of type I respiratory failure patients admitted to the respiratory intensive care unit (ICU). This randomized controlled clinical trial was carried out at Respiratory ICU, Chest Department, Zagazig University Hospital for 18 months, starting from July 2018. On admission, fifty-six enrolled patients with acute respiratory failure were randomized in a 1:1 ratio into the conventional group (oxygen therapy was supplied to maintain SpO2 between 94-97%) and the conservative group (oxygen therapy was administered to maintain SpO2 values between 88-92%). Different outcomes were assessed including ICU mortality, Need for mechanical ventilation (MV): invasive or non-invasive and ICU length of stay. In the current study, Pao2 was significantly higher among the conventional group, at all times after the baseline reading and HCO3 was significantly higher among the conventional group at the first two readings. There was no significant difference in Serum lactate level in follow-up readings. The mean duration of MV and ICU length of stay was (6.17±2.05 and 9.25±2.22) days in the conventional group versus (6.46±2.0 and 9.53±2.16) days in the conservative group respectively without significant difference between both groups. About 21.4% of conventional group patients died, while 35.7% of conservative group patients died without a significant difference between both groups. We concluded that conservative oxygen therapy may be applied safely in patients with type 1 acute respiratory failure.