PDF(Pubmed)
Abstract：
UNASSIGNED: Our aim was to confirm whether extreme hyperoxemic events had been associated with excess mortality in our diverse critical care population.
UNASSIGNED: Retrospective analysis of 9 years of data collected in the pediatric and cardiothoracic ICUs in Children\'s Hospital Los Angeles was performed. The analysis was limited to those mechanically ventilated for at least 24 h, with at least 1 arterial blood gas measurement. An extreme hyperoxemic event was defined as a PaO2 of ≥300 torr. Multivariable logistic regression was used to assess the association of extreme hyperoxemia events and mortality, adjusting for confounding variables. Selected a-priori, these were Pediatric Risk of Mortality III predicted mortality, general or cardiothoracic ICU, number of blood gas measurements, as well as an abnormal blood gas measurements (pH < 7.25, pH > 7.45, and PaO2 < 50 torr).
UNASSIGNED: There were 4,003 admissions included with a predicted mortality of 7.1% and an actual mortality of 9.7%. Their care was associated with 75,129 blood gas measurements, in which abnormal measurements were common. With adjustments for these covariates, any hyperoxemic event was associated with excess mortality (p < 0.001). Excess mortality increased with multiple hyperoxemic events (p < 0.046). Additionally, treatment resulting in SpO2 > 98% markedly increased the risk of a hyperoxemic event.
UNASSIGNED: Retrospective analysis of critical care admissions showed that extreme hyperoxemic events were associated with higher mortality. Supplemental oxygen levels resulting in SpO2 > 98% should be avoided.
UNASSIGNED: Retrospective analysis of 9 years of data collected in the pediatric and cardiothoracic ICUs in Children\'s Hospital Los Angeles was performed. The analysis was limited to those mechanically ventilated for at least 24 h, with at least 1 arterial blood gas measurement. An extreme hyperoxemic event was defined as a PaO2 of ≥300 torr. Multivariable logistic regression was used to assess the association of extreme hyperoxemia events and mortality, adjusting for confounding variables. Selected a-priori, these were Pediatric Risk of Mortality III predicted mortality, general or cardiothoracic ICU, number of blood gas measurements, as well as an abnormal blood gas measurements (pH < 7.25, pH > 7.45, and PaO2 < 50 torr).
UNASSIGNED: There were 4,003 admissions included with a predicted mortality of 7.1% and an actual mortality of 9.7%. Their care was associated with 75,129 blood gas measurements, in which abnormal measurements were common. With adjustments for these covariates, any hyperoxemic event was associated with excess mortality (p < 0.001). Excess mortality increased with multiple hyperoxemic events (p < 0.046). Additionally, treatment resulting in SpO2 > 98% markedly increased the risk of a hyperoxemic event.
UNASSIGNED: Retrospective analysis of critical care admissions showed that extreme hyperoxemic events were associated with higher mortality. Supplemental oxygen levels resulting in SpO2 > 98% should be avoided.
摘要：
■我们的目的是确认极端的高氧事件是否与我们不同的重症监护人群的高死亡率相关。
■对洛杉矶儿童医院儿科和心胸ICU收集的9年数据进行回顾性分析。分析仅限于机械通风至少24小时，至少测量1次动脉血气。极端高氧事件定义为PaO2≥300托。多变量logistic回归用于评估极端高氧血症事件与死亡率的关系。调整混杂变量。选定的先验，这些是儿科死亡率风险III预测死亡率，一般或心胸ICU，血气测量的数量，以及异常的血气测量（pH<7.25，pH>7.45和PaO2<50托）。
■有4,003例入院，预测死亡率为7.1％，实际死亡率为9.7％。他们的护理与75,129次血气测量有关，其中异常测量很常见。通过对这些协变量的调整，任何高氧事件均与超额死亡率相关(p<0.001).超额死亡率随多个高氧事件增加(p<0.046)。此外,导致SpO2>98%的治疗显著增加了高氧事件的风险.
■重症监护入院的回顾性分析显示，极端高氧事件与较高的死亡率相关。应避免导致SpO2>98%的补充氧水平。
■对洛杉矶儿童医院儿科和心胸ICU收集的9年数据进行回顾性分析。分析仅限于机械通风至少24小时，至少测量1次动脉血气。极端高氧事件定义为PaO2≥300托。多变量logistic回归用于评估极端高氧血症事件与死亡率的关系。调整混杂变量。选定的先验，这些是儿科死亡率风险III预测死亡率，一般或心胸ICU，血气测量的数量，以及异常的血气测量（pH<7.25，pH>7.45和PaO2<50托）。
■有4,003例入院，预测死亡率为7.1％，实际死亡率为9.7％。他们的护理与75,129次血气测量有关，其中异常测量很常见。通过对这些协变量的调整，任何高氧事件均与超额死亡率相关(p<0.001).超额死亡率随多个高氧事件增加(p<0.046)。此外,导致SpO2>98%的治疗显著增加了高氧事件的风险.
■重症监护入院的回顾性分析显示，极端高氧事件与较高的死亡率相关。应避免导致SpO2>98%的补充氧水平。
