# Low versus high peripheral oxygen saturation directed oxygen therapy in critically ill patients: a multicenter randomized controlled trial

## TL;DR

A study found that targeting lower oxygen levels in critically ill patients did not improve survival or recovery outcomes compared to higher oxygen levels.

## Contribution

This multicenter trial provides new evidence on the effectiveness of low versus high oxygen saturation targets in ICU patients.

## Key findings

- Low SpO2 therapy did not reduce 28-day mortality compared to high SpO2 therapy.
- Ventilator-free and RRT-free times were not significantly different between the groups.
- Lower FiO2 and SpO2 averages were observed in the low SpO2 group.

## Abstract

Whether low peripheral oxygen saturation (SpO2) directed oxygen therapy is associated with lower mortality in critically ill patients needs further exploration. Adult critically ill patients from 11 intensive care units in China were screened. Participants were randomly assigned to the low SpO2 (90%–95%) group or the high SpO2 (≥96%) ‐group. The primary outcome was 28‐day all‐cause mortality. The secondary outcomes were hours free from ventilators and from renal replacement therapy (RRT) within 14 days. Note that 857 patients in the low SpO2 group and 849 in the high SpO2 group were included. In the low SpO2 group versus the high SpO2 group, the time‐weighted average of the fraction of inspired oxygen (FiO2) was significantly lower (33.5 ± 9.7% vs. 39.6 ± 9.3%, p < 0.001), and so was the time‐weighted average of SpO2 (95.9 ± 1.8% vs. 98.0 ± 1.9%, p < 0.001). Within 28 days after randomization, 172 (20.1%) in the low SpO2 group and 193 (22.7%) in the high SpO2 group died (p = 0.180). Ventilator‐free time and RRT‐free time were not significantly different within 14 days. In critically ill patients, low SpO2directed oxygen therapy did not decrease 28‐day mortality, 14‐day ventilator‐free time, or 14‐day RRT‐free time.

In critically ill patients, SpO2‐directed oxygen therapy did not decrease 28‐day mortality, 14‐day ventilator‐free time, or 14‐day renal replacement therapy (RRT)‐free time in intensive care unit (ICU).