Volume 19 Supplement 1

35th International Symposium on Intensive Care and Emergency Medicine

Open Access

Association between high arterial oxygen tension and long-term survival after intracerebral hemorrhage

  • M Fallenius1,
  • R Raj1,
  • M Reinikainen2,
  • S Bendel3 and
  • MB Skrifvars1
Critical Care201519(Suppl 1):P465

https://doi.org/10.1186/cc14545

Published: 16 March 2015

Introduction

Liberal use of oxygen after brain insults remains controversial [1, 2]. We studied whether high arterial oxygen tension (PaO2) is associated with decreased long-term survival in patients with spontaneous intracerebral hemorrhage (ICH) treated in the ICU.

Methods

Data on primary admissions for adult patients (>18 years) treated for ICH in Finnish ICUs between 2003 and 2012 were collected from a nationwide ICU database. Patients were divided into three groups according to the PaO2 value associated with the lowest measured PaO2/ FIO2 ratio during the first 24 hours after ICU admission. High arterial oxygen tension was defined as PaO2 >19.9 kPa; intermediate as PaO2 13 to 19.9 kPa; and low as PaO2 <13 kPa. The primary outcome was 6-month mortality.

Results

Of the 3,033 patients, 63% (n = 1,923) had low PaO2, 29% (n = 892) intermediate PaO2, and 7% (n = 218) high PaO2. Forty-nine percent of the patients died during the 6-month follow-up. Of these, 75% died before discharge from hospital. Univariate analysis showed that 6-month mortality was higher in the high PaO2 group (61%) compared with the intermediate and low PaO2 groups (52% and 46% respectively, P < 0.001). Multivariate analysis, however, showed no statistically significant correlation between high PaO2 and mortality (with the low PaO2 group as the reference category, odds ratio for death (OR) for high PaO2 = 1.10, 95% confidence interval (CI) = 0.76 to 1.58 and for intermediate PaO2 = 0.96, 95% CI = 0.78 to 1.17).

Conclusion

High PaO2 is not predictive of 6-month mortality in patients treated for spontaneous ICH in the ICU. Therefore, targeting higher PaO2 values appears to be a safe approach in order to avoid hypoxemia.

Authors’ Affiliations

(1)
Helsinki University Hospital
(2)
North Karelia Central Hospital
(3)
Kuopio University Hospital

References

  1. Rincon F, Kang J, Maltenfort M, et al: Association between hyperoxia and mortality after stroke. Crit Care Med. 2014, 387-96. 42View ArticlePubMedGoogle Scholar
  2. de Jonge E, Peelen L, Keijzers PJ, et al: Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients. Crit Care. 2008, 12: R156-10.1186/cc7150.PubMed CentralView ArticlePubMedGoogle Scholar

Copyright

© Fallenius et al.; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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