Conservative versus Liberal Oxygenation in Chest Diseases

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Abstract Background Conservative oxygen therapy is a good alternative to liberal oxygen therapy, as it overcomes libral oxygen therapy induced hyperoxia and reduces its harmful and undesirable effects such as lung injury and, lung collapse, acute respiratory distress syndrome. Objective To systematically review the efficacy and safety of conservative versus liberal oxygen therapy, and to measure the caliber of trachea and main bronchi at the start and end of treatment by oxygen therapy to show if it has an effect on anteroposterior and transverse dimensions of trachea and main bronchi. Patients and Methods A prospective study was conducted on 72 subject were divided into 2 groups. 36 patients received liberal oxygen (group A), 36 patients received conservative oxygen (group B). Results In comparing the 2 groups, there was no statically significant difference between the two groups concerning hospital acquired infection but hospital acquired pneumonia was high in group A (p value < 0.05). Furthermore, length of hospital stay was statically significant higher in group A (p value < 0.001). Although arrhythmia was statically significant higher in group B (p value < 0.05). On other hand there was no statically difference between two groups as regarded vasopressor dose, new organ dysfunction, mechanical ventilation free days, attempts to lower use of mandatory MV mode which might indicate earlier attempts to wean patients, ARDS as a new complication, ICU mortality, hospital mortality and 30day mortality (p value > 0.05). Conclusion Both libral and conservative oxygen therapy have advantages and disadvantages, and we did not find a clear difference between both choices. Each of the two options is left to the physician, who decides to choose one of the two options according to his exeperience and the patient's condition.