Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxaemia

Crescioli, E; Nielsen, FM; Bunzel, AM; Eriksen, ASB; Siegemund, M; Poulsen, LM; Andreasen, AS; Bestle, MH; Iversen, SA; Brøchner, AC; Grøfte, T; Hildebrandt, T; Laake, JH; Kjær, MN; Lange, T; Perner, A; Klitgaard, TL; Schjørring, OL; Rasmussen, BS

doi:10.1007/s00134-024-07613-2

Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxaemia

Intensive Care MedPublished 5 Sep 2024Secondary analysis of the Handling Oxygenation Targets in COVID-19 randomised trial

Primary result · One-year mortalityResultAdjusted relative risk 0.85 98.6% CI 0.66–1.09

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Authors' conclusion

Among adult ICU patients with COVID-19 and severe hypoxaemia, one-year mortality results were most compatible with benefit of the lower oxygenation target, which did not appear to result in more survivors with poor quality of life.

Study context

Population: Adult intensive care unit (ICU) patients with COVID-19 and severe hypoxaemia691 with one-year vital status
Participants: 726 patients

Comparison: PaO2 target 8 kPa vs 12 kPa during ICU stay up to 90 days
Primary endpoint: Mortality
Follow-up: One year

Methodological detailspre-planned analyses, intention-to-treat, health-related quality of life (HRQoL) data obtained for 642/726 (88.4%)

Pre-planned analyses
Intention-to-treat
HRQoL data obtained for 642/726 (88.4%)

Primary result

One-year mortality

Adjusted relative risk

0.85

98.6% CI 0.66–1.09

P = 0.11

Events by treatment group

Lower oxygenation33.6%117 events

Higher oxygenation39.1%134 events

Lower oxygenation vs Higher oxygenation

adjusted RR 0.85 (98.6% CI 0.66–1.09); P = 0.11

As reported in the abstract

Further findings

Median

Outcome	Lower oxygenation	Higher oxygenation	← Lower with lower oxygenation ←→ Higher with lower oxygenation →	Adjusted mean difference (98.6% CI)	P value
EQ-VAS (non-survivors scored 0; multiple imputation) · one year	50 (IQR 0–80)	40 (IQR 0–75)	−5051015	4.8 (- 2.2 to 11.9)	P = 0.09
			−5051015Difference (linear scale)

Outcome	Lower oxygenation	Higher oxygenation	P value
EQ-5D-5L index value · one year	0.61 (IQR 0–0.81)	0.43 (IQR 0–0.79)	P = 0.20

Original publication

Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxaemia. Intensive Care Med. Published 5 September 2024. doi:10.1007/s00134-024-07613-2

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