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Lookup NU author(s): Dr Rachel Agbeko
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© 2024 Lippincott Williams and Wilkins. All rights reserved.Objectives: A conservative oxygenation strategy, targeting peripheral oxygen saturations (Spo2) between 88% and 92% in mechanically ventilated children in PICU, was associated with a shorter duration of organ support and greater survival compared with Spo2greater than 94% in our recent Oxy-PICU trial. Spo2monitors may overestimate arterial oxygen saturation (Sao2) in patients with higher levels of skin pigmentation compared with those with less skin pigmentation. We investigated if ethnicity was associated with changes in distributions of Spo2and Fio2and outcome. Design: Post hoc analysis of a pragmatic, open-label, multicenter randomized controlled trial. Setting: Fifteen PICUs across the United Kingdom and Scotland. Patients: Children aged 38 weeks corrected gestational age to 15 years accepted to a participating PICU as an unplanned admission and receiving invasive mechanical ventilation with supplemental oxygen for abnormal gas exchange. Methods: Hierarchical regression models for Spo2and Fio2, and ordinal models for the primary trial outcome of a composite of the duration of organ support at 30 days and death, were used to examine the effects of ethnicity, accounting for baseline Spo2, Fio2, and mean airway pressure and trial allocation. Measurements and Main Results: Ethnicity data were available for 1577 of 1986 eligible children, 1408 (89.3%) of which were White, Asian, or Black. Spo2and Fio2distributions did not vary according to Black or Asian ethnicity compared with White children. The trial primary outcome measure also did not vary significantly with ethnicity. The point estimate for the treatment effect of conservative oxygenation in Black children was 0.64 (95% CI, 0.33-1.25) compared with 0.84 (0.68-1.04) in the overall trial population. Conclusions: These data do not suggest that the association between improved outcomes and conservative oxygenation strategy in mechanically ventilated children in PICU is modified by ethnicity.
Author(s): Jones GAL, Wiegand M, Ray S, Gould DW, Agbeko R, Giallongo E, Charles WN, Orzol M, O'Neill L, Lampro L, Lillie J, Pappachan J, Ramnarayan P, Harrison DA, Mouncey PR, Peters MJ
Publication type: Article
Publication status: Published
Journal: Pediatric Critical Care Medicine
Year: 2024
Pages: epub ahead of print
Online publication date: 19/07/2024
Acceptance date: 02/04/2024
ISSN (print): 1529-7535
ISSN (electronic): 1947-3893
Publisher: Lippincott Williams and Wilkins
URL: https://doi.org/10.1097/PCC.0000000000003583
DOI: 10.1097/PCC.0000000000003583
PubMed id: 39028216
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