Conservative versus liberal oxygen therapy for intensive care unit patients: meta-analysis of randomized controlled trials

Li, Xin-yu; Dai, Bing; Hou, Hai-jia; Zhao, Hong-wen; Wang, Wei; Kang, Jian; Tan, Wei

doi:10.1186/s13613-024-01300-7

Annals of Intensive Care

Table 1 Characteristics of the studies included

From: Conservative versus liberal oxygen therapy for intensive care unit patients: meta-analysis of randomized controlled trials

Study	Country	Study design	Group	Simple size (Total, Medical, Surgical, n)	Baseline PaO₂/FiO₂ (mmHg)	Targeted SpO₂,% (PaO₂, mmHg)	Actual PaO₂^# (mmHg)	Mortality (30-,90-day,%)
Mortality (LOT-COT > 5%)
Asfar 2017 [42]	France	Multicenter RCT	COT	223, ND	228 ± 103	88–95	84.3 ± 20.2	35.5%, 41.5%
Asfar 2017 [42]	France	Multicenter RCT	LOT	219, ND	220 ± 103	FiO₂:1.0	87.3 ± 22.4	42.9%, 47.9%
Girardis 2016 [11]	Italy	Single-center, open-label RCT	COT	236, 77, 139	≥ 150	94–98 (70–100)	87.7 ± 13.4	16.2%, ND
Girardis 2016 [11]	Italy	Single-center, open-label RCT	LOT	244, 86, 132	≥ 150	97–100 (up to 150)	102.0 ± 20.9	25.2%, ND
Yang 2019 [37]	China	Multicenter RCT	COT	100, 88, 12	≥ 100	90–95	84.7 ± 21.1	26.0%, ND
Yang 2019 [37]	China	Multicenter RCT	LOT	114, 94, 14	≥ 100	96–100	97.7 ± 27.8	32.5%, ND
Mortality (LOT-COT − 5% ~ 5%)
Gelissen 2021 [43]	Netherlands	Multicenter RCT	COT	294, 143, 50	PaO₂:92.8 ± 36.4, FiO₂:0.48 ± 0.16	ND (60–90)	81.4 ± 12.5	ND, 35.1%
Gelissen 2021 [43]	Netherlands	Multicenter RCT	LOT	280, 139, 41	PaO₂:93.8 ± 24.6, FiO₂:0.49 ± 0.15	ND (105–135)	96.5 ± 22.4	ND, 34.4%
Mackle 2020 [38]	Australia and New Zealand	Multicenter RCT	COT	499, 335, 149	259 ± 146	91–96	83.1 ± 2.8	31.8%, 34.7%
Mackle 2020 [38]	Australia and New Zealand	Multicenter RCT	LOT	501, 335, 146	245 ± 138	≥ 91	94.9 ± 4.5	29.1%, 32.5%
Nielsen 2024 [28]	Denmark, Switzerland, Norway, Iceland, and Wales	Multicenter RCT	COT	365, 362, 0	94.7 ± 38.0	ND (60)	71.3 ± 5.2	30.2%
Nielsen 2024 [28]	Denmark, Switzerland, Norway, Iceland, and Wales	Multicenter RCT	LOT	361, 358, 0	98.0 ± 37.2	ND (90)	90.3 ± 8.9	34.7%
Panwar 2016 [36]	Australia, France and New Zealand	Multicenter, multinational RCT	COT	53, 39, 10	248 ± 112	88–92	70.3 ± 3.8	ND, 40.4%
Panwar 2016 [36]	Australia, France and New Zealand	Multicenter, multinational RCT	LOT	51, 41, 8	247 ± 113	≥ 96	92.3 ± 5.3	ND, 37.3%
Rasmussen [46]^*	Substudy of HOT-ICU [39]		COT	54, 54, 0	109.3 ± 49.7	ND (60)	70.8 ± 4.6	ND, 40.7%
Rasmussen [46]^*	Substudy of HOT-ICU [39]		LOT	56, 56, 0	100.5 ± 41.7	ND (90)	92.0 ± 8.0	ND, 41.8%
Schjørring 2021 [39]	Denmark, Switzerland, Finland, Netherlands, Norway, UK and Iceland	Multicenter RCT	COT	1462, 1248, 205	121.6 ± 51	ND (60)	71.3 ± 7.3	ND, 42.9%
Schjørring 2021 [39]		Multicenter RCT	LOT	1466, 1240, 217	120.4 ± 47.3	ND (90)	93.0 ± 8.6	ND, 42.4%
Semler 2022 [44]	USA	Cluster-crossover RCT	COT	963^a, ND 992^b, ND	PaO₂:97.7 ± 58.7, FiO₂:0.32 ± 0.18^a PaO₂:107.7 ± 64.6,FiO₂:0.37 ± 0.19^b	88–92 (55–65)^a, 92–96 (65–80)^b	70.8^a 82.7^b	34.8%, ND 34.0%, ND
Semler 2022 [44]	USA	Cluster-crossover RCT	LOT	1032^c, ND	PaO₂:103.7 ± 62.4,FiO₂:0.48 ± 0.15^c	96–100 (> 80)^c	90.2^c	33.2%, ND
van der Wal 2023 [27]	Netherlands and Italy	Multicenter RCT	COT	439, 258, 76	≥ 150	91–94 (55–80)	76.1 ± 10.2	38.5%, 43.0%
van der Wal 2023 [27]	Netherlands and Italy	Multicenter RCT	LOT	443, 251, 78	≥ 150	96–100 (110–150)	114.8 ± 21.4	34.7%, 40.4%
Mortality (COT-LOT > 5%)
Barrot 2020 [41]	France	Multicenter RCT	COT	103, ND	116.8 ± 47.4	88–92 (55–70)	71.3 ± 3.2	34.3%, 44.4%
Barrot 2020 [41]	France	Multicenter RCT	LOT	102, ND	120.1 ± 53.6	≥ 96 (90–105)	100.6 ± 6.7	26.5%,30.4%
Klitgaard [47]^*	Substudy of HOT-ICU [39]		COT	82, 82, 4	120.8 ± 53.2	ND (60)	72.5 ± 10.2	ND, 65.4%
Klitgaard [47]^*	Substudy of HOT-ICU [39]		LOT	86, 86, 6	119.0 ± 53.2	ND (90)	95.3 ± 7.4	ND, 54.6%
Martin 2021 [40]	England	Single-center RCT	COT	17, 17, 0	PaO₂:86.3 ± 18.0 FiO₂:0.43 ± 0.12	88–92	65.0 ± 8.5	31.3%, 40.0%
Martin 2021 [40]	England	Single-center RCT	LOT	17, 17, 0	PaO₂:86.3 ± 18.0 FiO₂:0.43 ± 0.12	No restrictions	90.3 ± 22.4	29.4%, 31.3%
Nafae 2023 [45]	Egypt	Single-center RCT	COT	28, 28, 0	129.36 ± 32.6	88–92	61.4 ± 3.1	ND, 35.7%
Nafae 2023 [45]	Egypt	Single-center RCT	LOT	28, 28, 0	120.36 ± 28.63	94–97	76.7 ± 5.4	ND, 21.4%

UK: United Kingdom; USA: United States of America; RCT: randomized controlled trial; COT: conservative oxygen therapy; LOT: liberal oxygen therapy; ND: No date
^aIn a lower SpO₂ target (90%; goal range, 88 to 92%)
^bIn an intermediate SpO₂ target (94%; goal range, 92 to 96%)
^cIn a higher SpO₂ target (98%; goal range, 96 to 100%)
^*Substudy of HOT-ICU [39]
^#Actual PaO₂ obtained for the longest follow-up (72 h-90 days) included in the study

Back to article page