Oxygen Therapy in the ICU

A review of the evidence

The lecture duration is 43min.

0.75 CPD Points, 0.75 CEUs, 0.75 CME credits approval pending.
Accredited by CPDUK, CBRN and Provider Pending.

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Paul Young
Consultant and Researcher in Intensive Care, Wellington, New Zealand
Lecture Summary

Provision of invasive mechanical ventilation is required for most critically ill patients admitted to an intensive care unit (ICU). Delivery of supplemental oxygen to ICU patients receiving mechanical ventilation often exposes them to a high fraction of inspired oxygen (FIO2) and higher than normal arterial oxygen partial pressure (PaO2). Humans are adapted to breathe air and it is plausible exposure to higher amounts of oxygen, either PaO2, FIO2, or both, might be harmful. Despite this, the optimal oxygen regimen in critically ill patients remains uncertain. This talk will focus on existing evidence around oxygen therapy mechanically ventilated ICU patients and on the design of the Mega-ROX trial, 40000 patient RCT comparing conservative oxygen therapy and liberal oxygen therapy, which has recently begun enrolling patients.

Target Audience

Critical Care Doctors
Experienced or advanced Critical Care Nurses

Learning Objectives:

Upon completion of this activity, you should be able to:

  • Describe the potential biological basis for harm associated with liberal oxygen therapy in mechanically ventilated adults who are critically ill
  • Explain the findings of the ICU-ROX trial
  • Summarise evidence from other randomised controlled trials evaluating oxygen therapy in the ICU
  • Outline the key design features of the Mega-ROX trial

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