Abdelbaky Ahmed M, Elmasry Wael G, Awad Ahmed H
Intensive Care Unit, Dubai Academic Health Corporation - Rashid Hospital, Dubai, ARE.
Cureus. 2023 Jul 3;15(7):e41330. doi: 10.7759/cureus.41330. eCollection 2023 Jul.
Supplemental oxygen is a standard therapeutic intervention for critically ill patients such as patients suffering from cardiac arrest, myocardial ischemia, traumatic brain injury, and stroke. However, the optimal oxygenation targets remain elusive owing to the paucity and inconsistencies in the relevant literature. A comprehensive analysis of the available scientific evidence was performed to establish the relative efficacy of the lower and higher oxygenation targets. A systematic literature search was conducted in PubMed, MEDLINE, and Scopus databases from 2010 to 2023. Further, Google Scholar was also searched. Studies evaluating the efficacy of oxygenation targets and the associated clinical outcomes were included. Studies that included participants with hyperbaric oxygen therapy, chronic respiratory diseases, or extracorporeal life support were excluded. The literature search was performed by two blinded reviewers. A total of 19 studies were included in this systemic review, including 72,176 participants. A total of 14 randomized control trials were included. A total of 12 studies investigated the efficacy of lower and higher oxygenation targets in ICU-admitted patients, and seven were assessed in patients with acute myocardial infarction and stroke. For ICU patients, the evidence was conflicting, with some studies showing the efficacy of conservative oxygen therapy while others reported no difference. Overall, nine studies concluded that lower oxygen targets are favorable. However, most studies (n=4) in stroke and myocardial infarction patients showed no difference in lower or higher oxygenation targets whereas only two supported lower oxygenation targets. Available evidence suggests that lower oxygenation targets result in either improved or equivalent clinical outcomes compared with higher oxygenation targets.
补充氧气是对危重病患者（如心脏骤停、心肌缺血、创伤性脑损伤和中风患者）的标准治疗干预措施。然而，由于相关文献的匮乏和不一致，最佳氧合目标仍然难以确定。为了确定较低和较高氧合目标的相对疗效，对现有科学证据进行了全面分析。在2010年至2023年期间，在PubMed、MEDLINE和Scopus数据库中进行了系统的文献检索。此外，还搜索了谷歌学术。纳入了评估氧合目标疗效及相关临床结果的研究。排除了包括接受高压氧治疗、慢性呼吸系统疾病或体外生命支持的参与者的研究。文献检索由两名盲法评审员进行。本系统评价共纳入19项研究，包括72176名参与者。共纳入14项随机对照试验。共有12项研究调查了较低和较高氧合目标对入住重症监护病房（ICU）患者的疗效，7项研究对急性心肌梗死和中风患者进行了评估。对于ICU患者，证据相互矛盾，一些研究表明保守氧疗有效，而另一些研究则报告无差异。总体而言，9项研究得出结论，较低的氧目标是有利的。然而，大多数关于中风和心肌梗死患者的研究（n=4）表明，较低或较高的氧合目标没有差异，而只有两项研究支持较低的氧合目标。现有证据表明，与较高的氧合目标相比，较低的氧合目标可带来改善或相当的临床结果。
