Conservative versus liberal oxygenation targets for mechanically ventilated patients-a pilot multicenter randomized controlled trial.

Abstract

Panwar and colleagues recently reported the results of a prospective multicenter international interventional trial comparing two oxygenation targets in all-comer patients receiving invasive mechanical ventilation in ICU, namely a conservative (SpO2 88–92%) versus a liberal target (≥96%), by accommodating FIO2 (1). The rationale behind this was that no previous trial was done to compare different oxygenation goals in mechanically ventilated patients. Even though oxygen therapy is frequently used in the critical care setting, its goals are not well defined. The primary outcome was the area under curve of transcutaneous oxygen saturation (SpO2). They included 104 patients in both groups and found that the primary end-point was significantly lower in the conservative than in the liberal group. From this result the authors concluded that reaching a conservative oxygenation target is feasible, which will serve for an upcoming large trial testing these two oxygenation levels. We would like to split the present editorial into three sections. The first is about the pathophysiological rationale of the study. The second deals with the methodology and the results of the trial. The third will discuss its strengths and limitations.