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Rasmussen BS, Klitgaard TL, Perner A, et al. Oxygenation targets in ICU patients with COVID-19: A post hoc subgroup analysis of the HOT-ICU trial. Acta Anaesthesiol Scand. 2021;66(1):76-84doi: 10.1111/aas.13977.
Rasmussen, B. S., Klitgaard, T. L., Perner, A., Brand, B. A., Hildebrandt, T., Siegemund, M., Hollinger, A., Aagaard, S. R., Bestle, M. H., Marcussen, K. V., Brøchner, A. C., Sølling, C. G., Poulsen, L. M., Laake, J. H., Aslam, T. N., Bäcklund, M., Okkonen, M., Morgan, M., Sharman, M., Lange, T., Wetterslev, J., & Schjørring, O. L. (2022). Oxygenation targets in ICU patients with COVID-19: A post hoc subgroup analysis of the HOT-ICU trial. Acta anaesthesiologica Scandinavica, 66(1), 76-84. https://doi.org/10.1111/aas.13977
Rasmussen, Bodil S, et al. "Oxygenation targets in ICU patients with COVID-19: A post hoc subgroup analysis of the HOT-ICU trial." Acta anaesthesiologica Scandinavica vol. 66,1 (2022): 76-84. doi: https://doi.org/10.1111/aas.13977
Rasmussen BS, Klitgaard TL, Perner A, Brand BA, Hildebrandt T, Siegemund M, Hollinger A, Aagaard SR, Bestle MH, Marcussen KV, Brøchner AC, Sølling CG, Poulsen LM, Laake JH, Aslam TN, Bäcklund M, Okkonen M, Morgan M, Sharman M, Lange T, Wetterslev J, Schjørring OL. Oxygenation targets in ICU patients with COVID-19: A post hoc subgroup analysis of the HOT-ICU trial. Acta Anaesthesiol Scand. 2022 Jan;66(1):76-84. doi: 10.1111/aas.13977. Epub 2021 Sep 20. PMID: 34425016; PMCID: PMC8653379.
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Acta Anaesthesiol Scand. 2022 Jan;66(1):76-84. doi: 10.1111/aas.13977. Epub 2021 Sep 20.

Oxygenation targets in ICU patients with COVID-19: A post hoc subgroup analysis of the HOT-ICU trial.

Acta anaesthesiologica Scandinavica

Bodil S Rasmussen, Thomas L Klitgaard, Anders Perner, Björn A Brand, Thomas Hildebrandt, Martin Siegemund, Alexa Hollinger, Søren R Aagaard, Morten H Bestle, Klaus V Marcussen, Anne C Brøchner, Christoffer G Sølling, Lone M Poulsen, Jon H Laake, Tayyba N Aslam, Minna Bäcklund, Marjatta Okkonen, Matthew Morgan, Mike Sharman, Theis Lange, Jørn Wetterslev, Olav L Schjørring

Affiliations

  1. Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.
  2. Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark.
  3. Center for Research in Intensive Care, Rigshospitalet, Copenhagen, Denmark.
  4. Department of Intensive Care, Rigshospitalet, University of Copenhagen, Denmark.
  5. Department of Anaesthesia and Intensive Care, Zealand University Hospital, Roskilde, Denmark.
  6. Department of Anaesthesia and Intensive Care, Basel University Hospital, Basel, Switzerland.
  7. Department of Clinical Research, University of Basel, Basel, Switzerland.
  8. Department of Anaesthesia and Intensive Care, Nordsjaellands Hospital, Hilleroed, Denmark.
  9. Department of Anaesthesia and Intensive Care, Slagelse Hospital, Slagelse, Denmark.
  10. Department of Anaesthesia and Intensive Care, Kolding Hospital, Kolding, Denmark.
  11. Department of Anaesthesia and Intensive Care, Viborg Hospital, Viborg, Denmark.
  12. Department of Anaesthesia and Intensive Care, Zealand University Hospital, Køge, Denmark.
  13. Department of Anaesthesia and Intensive Care, Oslo University Hospital Rikshospitalet, Oslo, Norway.
  14. Department of Anaesthesia and Intensive Care, Helsinki University Hospital, Helsinki, Finland.
  15. Department of Intensive Care, University Hospital of Wales, Cardiff, UK.
  16. Department of Intensive Care and Respiratory Medicine, Manchester University NHS Foundation Trust, Manchester Royal Infirmary, Manchester, UK.
  17. Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
  18. Copenhagen Trial Unit, Copenhagen, Denmark.

PMID: 34425016 PMCID: PMC8653379 DOI: 10.1111/aas.13977

Abstract

BACKGROUND: Supplemental oxygen is the key intervention for severe and critical COVID-19 patients. With the unstable supplies of oxygen in many countries, it is important to define the lowest safe dosage.

METHODS: In spring 2020, 110 COVID-19 patients were enrolled as part of the Handling Oxygenation Targets in the ICU trial (HOT-ICU). Patients were allocated within 12 h of ICU admission. Oxygen therapy was titrated to a partial pressure of arterial oxygen (PaO

RESULTS: At 90 days, 22 of 54 patients (40.7%) in the lower oxygenation group and 23 of 55 patients (41.8%) in the higher oxygenation group had died (adjusted risk ratio: 0.87; 95% confidence interval, 0.58-1.32). The percentage of days alive without life support was significantly higher in the lower oxygenation group (p = 0.03). The numbers of severe ischemic events were low with no difference between the two groups. Proning and inhaled vasodilators were used more frequently, and the positive end-expiratory pressure was higher in the higher oxygenation group. Tests for interactions with the results of the remaining HOT-ICU population were insignificant.

CONCLUSIONS: Targeting a PaO

TRIAL REGISTRATION NUMBER: ClinicalTrials.gov number, NCT03174002. Date of registration: June 2, 2017.

© 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Keywords: intensive care units; oxygen inhalation therapy; randomized controlled trial; respiratory insufficiency; severe acute respiratory syndrome coronavirus 2

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