Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark.
Centre for Research in Intensive Care, Copenhagen University Hospital, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2018 Aug;62(7):1020-1030. doi: 10.1111/aas.13127. Epub 2018 Apr 30.
In critically ill patients, hypoxaemia is a common clinical manifestation of inadequate gas exchange in the lungs. Supplemental oxygen is therefore given to all critically ill patients. This can result in hyperoxaemia, and some observational studies have identified harms with hyperoxia. The objective of this systematic review is to critically assess the evidence of randomised clinical trials on the effects of higher versus lower inspiratory oxygen fractions or targets of arterial oxygenation in critically ill adult patients.
We will search for randomised clinical trials in major international databases. Two authors will independently screen and select references for inclusion using Covidence, extract data and assess the methodological quality of the included randomised clinical trials using the Cochrane risk of bias tool. Any disagreement will be resolved by consensus. We will analyse the extracted data using Review Manager and Trial Sequential Analysis. To assess the quality of the evidence, we will create a 'Summary of Findings' table containing our primary and secondary outcomes using the GRADE assessment.
Supplemental oxygen administration is widely recommended in international guidelines despite lack of robust evidence of its effectiveness. To our knowledge, no systematic review of randomised clinical trials has investigated the effects of oxygen supplementation in critically ill patients. This systematic review will provide reliable evidence to better inform future trialists and decision-makers on clinical practice on supplemental oxygen administration in critically ill patients.
在危重症患者中，低氧血症是肺部气体交换不足的常见临床表现。因此，所有危重症患者都给予补充氧气。这可能导致高氧血症，一些观察性研究已经确定了高氧血症的危害。本系统评价的目的是批判性地评估关于高氧与低氧吸入氧分数或动脉氧合目标在成年危重症患者中的影响的随机临床试验证据。
我们将在主要国际数据库中搜索随机临床试验。两名作者将使用 Covidence 独立筛选和选择纳入的参考文献，使用 Cochrane 偏倚风险工具提取数据并评估纳入的随机临床试验的方法学质量。任何分歧将通过协商解决。我们将使用 Review Manager 和 Trial Sequential Analysis 分析提取的数据。为了评估证据的质量，我们将使用 GRADE 评估创建一个包含主要和次要结局的“结果总结”表。
尽管缺乏其有效性的可靠证据，但补充氧气的给药在国际指南中被广泛推荐。据我们所知，尚无系统评价随机临床试验研究过危重症患者补充氧气的效果。本系统评价将提供可靠的证据，以更好地为未来的试验人员和决策者提供有关危重症患者补充氧气给药的临床实践信息。
