Admission Pao 2 and Mortality in Critically Ill Children: A Cohort Study and Systematic Review

Sainath Raman; N. J. Prince; Aparna Hoskote; Samiran Ray; Mark Peters

doi:10.1097/pcc.0000000000000905

August 10, 2016Pediatric Critical Care Medicine

Admission Pao 2 and Mortality in Critically Ill Children: A Cohort Study and Systematic Review

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Key Points

To evaluate the relationship between arterial oxygen tension (PaO2) at pediatric intensive care admission and subsequent mortality using an institutional cohort and a systematic review.
Analyzed a retrospective single-center cohort of 7,410 pediatric intensive care admissions (under 18 years of age) with recorded admission PaO2 and FiO2 between 2004 and 2014 using nonlinear regression.
Conducted a systematic review of MEDLINE, EMBASE, Cochrane, and DARE through January 2015 to assess mortality associated with hypoxia (PaO2 < 8 kPa or SpO2 < 90%) and hyperoxia (PaO2 > 40 kPa).
In the cohort study, crude mortality was 7.4% (555/7,410) overall, occurring in 15.4% (204/1,324) of hypoxic patients, 5.3% (287/5,385) of normoxic patients, and 9.1% (64/701) of hyperoxic patients, establishing a U-shaped relationship with adjusted mortality.
The systematic review demonstrated that hypoxia significantly increased odds of death compared to normoxia (11 studies, n = 5,280; OR 3.13, 95% CI 1.79–5.48; p < 0.001), whereas hyperoxia showed no statistically significant effect (6 studies, n = 2,012; OR 1.15, 95% CI 0.42–3.17; p = 0.77).

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Implication

A cohort study and systematic review reveals a U-shaped link between admission PaO2 and mortality in critically ill children, indicating risks from both hypoxia and hyperoxia.

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Cite This Study

Raman et al. (2016) studied this question.

synapsesocial.com/papers/6a8c4534c17aa55aa6e8d5ae https://doi.org/10.1097/pcc.0000000000000905

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Admission Pao 2 and Mortality in Critically Ill Children: A Cohort Study and Systematic Review

Key Points

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Implication

Discussion

Cite This Study

Admission Pao 2 and Mortality in Critically Ill Children: A Cohort Study and Systematic Review

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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