Association Between High Arterial Oxygen Tension and Long-Term Survival After Spontaneous Intracerebral Hemorrhage

作者：Fallenius Marika^*; Raj Rahul; Reinikainen Matti; Bendel Stepani; Skrifvars Markus B

来源：Critical Care Medicine, 2016, 44(1): 180-187.

DOI：10.1097/CCM.0000000000001281

• intensive care
• intracerebral hemorrhage
• mortality
• oxygen
• stroke

Objective: To determine the relation between high arterial oxygen tension levels (Pao(2)) and long-term mortality in patients with spontaneous intracerebral hemorrhage treated in the ICU.
Design: National observational multicenter cohort study.
Setting: Twenty-one ICUs in Finland.
Patients: A total of 3,033 adult patients.
Interventions: None.
Measurements and Main Results: Patients were divided into high (> 150mm Hg), intermediate (97.5-150mm Hg), and low (< 97.5mm Hg) Pao(2) groups based on the lowest measured Pao(2)/Fio(2) ratio during the first 24 hours after ICU admission: 63% (n = 1,923) were in the low group, 29% (n = 892) were in the intermediate group, and 7% (n = 218) were in the high group; 80% were mechanically ventilated. The primary outcome was 6-month mortality, which occurred in 49% of patients and was significantly more frequent in the high Pao(2) group than in the intermediate and low Pao(2) groups (61% vs 52% and 46%, respectively, p < 0.001). In univariate analysis, patients in the high Pao(2) group had a significantly increased risk of 6-month mortality compared with the low Pao(2) group (odds ratio, 1.82; 95% CIs, 1.36-2.42; p < 0.001), but this statistically significant relation was lost after adjusting for markers of severity of illness in a logistic mixed-effects regression model (odds ratio, 1.10; 95% CI, 0.76-1.60; p = 0.598).
Conclusions: No significant relation between Pao(2) levels and long-term mortality was found. The clinical role of hyperoxemia in patients with intracerebral hemorrhage treated in the ICU remains controversial and warrants further studies.

• 出版日期2016-1