Supra-physiological Oxygenation Literature Summaries

Danek, S. et al (1980) “The dependence of oxygen uptake on oxygen delivery in adult respiratory distress syndrome” Am Rev Respir Dis 122:387-395

• some critically ill patients have an imbalance between oxygen supply and demand
  -> unmet metabolic demand despite normal ranges of oxygen delivery

Shoemaker, W.C., et al (1988) “Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients” Chest 94:1176-1186

• increasing tissue supply of O2 may reduce mortality and morbidity
• goal = attempt to find a benefit for ‘supranormal oxygen delivery’
• n = small
• supranormal O2 delivery VS standard care
  -> reduction in mortality reported
  -> heavily criticised study (not randomized, lack of similarity between treatment and control)

Gattinoni, L., et al (1995) “A trial of goal-oriented hemodynamic therapy in critically ill patients. SvO2 Collaborative Group.” N Engl J Med 333:1025-1032

• n = 762
• 3 groups: control, cardiac index and oxygen saturation
  -> no benefit shown

Hayes, M.A., et al (1994) “Elevation of systemic oxygen delivery in the treatment of critically ill patients.” N Engl J Med 330:1717-1722

-> increase morbidity and mortality