Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU)

What is the impact of conservative oxygenation targets (SpO2 88–92%) compared to liberal oxygenation targets (SpO2 >94%) on the duration of organ support or incidence of death within 30 days in critically ill children admitted to pediatric intensive care units and requiring invasive ventilation and supplemental oxygen?

Population: Critically ill children admitted as emergencies to PICUs, aged between 38 weeks corrected gestational age and under 16 years, requiring invasive ventilation and supplemental oxygen. The study included 1872 children out of 2040 randomized, with a near-equal distribution of genders in both groups.

Intervention: Conservative oxygenation target set at peripheral oxygen saturations (SpO2) of 88–92%. The group comprised 939 children.

Comparison: Liberal oxygenation target with SpO2 levels above 94%. This group included 933 children.

Outcome: The conservative oxygenation group showed a significant reduction in the duration of organ support or death within the first 30 days, with a probabilistic index of 0.53 (indicating over 50% probability of conservative oxygenation being superior), and a lower incidence of prespecified adverse events (3% in the conservative group vs. 4% in the liberal group).

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01968-2/fulltext