The association between early arterial oxygenation and mortality in ventilated patients with acute ischaemic stroke

Paul Michael Young, Richard Beasley, Michael John Bailey, Rinaldo Bellomo, Glenn M Eastwood, Alistair D Nichol, David V Pilcher, Nor'azim Yunos, Moritoki Egi, Graeme Keith Hart, Michael C Reade, David James Cooper

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Abstract

Background: There are conflicting data that suggest that hyperoxia may be associated with either worse or better outcomes in patients suffering a stroke. Objectives: To investigate the association between PaO 2 in the first 24 hours in the intensive care unit and mortality among ventilated patients with acute ischaemic stroke. Design: Retrospective cohort study. Setting: Data were extracted from the Australian and New Zealand Intensive Care Society Adult Patient Database. Participants: Adults ventilated for ischaemic stroke in 129 ICUs in Australia and New Zealand, 2000-2009. Main outcome measures: The primary outcome was the odds ratio for inhospital mortality associated with "worst" PaO 2 considered as a categorical variable, with data divided into deciles and compared with the mortality of the 10th decile. For patients on an FiO 2 of ≥50% at any time in the first 24 hours, "worst" PaO 2 was defined as the PaO 2 associated with the highest alveolar-arterial (A-a) gradient. For patients on an FiO 2 of <50%, it was defined as the lowest PaO 2. Secondary outcomes were ICU and hospital length of stay and the proportion of patients in each decile discharged home. Results: Of the 2643 patients eligible for study inclusion, 1507 (57%) died in hospital. The median "worst" PaO 2 was 117mmHg (interquartile range, 87-196mmHg). There was no association between worst PaO 2 and mortality, length of stay or likelihood of discharge home. Conclusions: We found no association between worst arterial oxygen tension in the first 24 hours in ICU and outcome in ventilated patients with ischaemic stroke.

Original languageEnglish
Pages (from-to)14-19
Number of pages6
JournalCritical Care and Resuscitation
Volume14
Issue number1
Publication statusPublished - Mar 2012

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