High inspiratory oxygen concentrations and high arterial oxygen pressures (PaO2) are independently associated with higher mortality in ICU patients. Although (inter)national guidelines advocate low (physiological) oxygenation targets, ICU-patients in the Netherlands achieve much higher PaO2 values.
Conditions
Interventions
The study phases:
1. Retrospective: Baseline measurement over 12-months period. They include in-hospital mortality, ICU-mortality, number of days alive and without artificial ventilation at 28 days a
2. First implementation phase. This phase will consist of providing a written guideline with clear recommendations how to adapt oxygen administration and ventilator settings depending on arterial bloo
3. Introduction decision-support. The decision-support will be based on exactly the same targets as the guideline from phase 2 and will work in the active, critiquing mode, meaning that it will give d
Sponsors
Leiden University Medical Center
Eligibility
Inclusion criteria
Inclusion criteria: All ICU patients admitted during the studyperiod at 3 ICUs, with subgroup analysis in all patients on mechanical ventilation.
Exclusion criteria
Exclusion criteria: Patients on extracorporeal membrane oxygenation (ECMO).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary End-points will include an analysis of the process of implementation, specifically the mean proportion (per patient) of PaO2 measurements within target range (primary endpoint), mean PaO2 and FiO2, and mean proportion of PaO2 measurements > 16 kPa (hyperoxia). Additional endpoint is the subjective judgement and appreciation of the guideline and the oxygenation targets by physicians and nurses. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary End-points, Outcome: Hospital mortality, ICU-mortality and days alive and without mechanical ventilation at 28 days after ICU admission. Outcome endpoints will be studied in all ICU patients and in a subgroup of patients that had mechanical ventilation at any time during ICU-stay. | — |
Contacts
Public ContactEvert Jonge, de
PO-box 9600
Outcome results
None listed