Oxygenation Targets and Long-Term Cognitive and Pulmonary Functions in Hypoxemic Respiratory Failure: A Clinical Trial.

Background

We sought to assess the effects of a PaO2 target of 60 versus 90 mm Hg on 1-year cognitive and pulmonary functions in ICU survivors of acute hypoxemic respiratory failure.

我们试图评估氧分压（PaO2）目标为60毫米汞柱与90毫米汞柱对急性低氧性呼吸衰竭重症监护病房（ICU）幸存者1年认知和肺功能的影响。

Methods

A total of 3,654 patients were randomized in the Handling Oxygenation Targets in the ICU and the Handling Oxygenation Targets in COVID-19 trials: 1,916 (52.4%) survived at 1 year, of which 1,244 (64.9%) were eligible.

在ICU氧气目标处理和COVID-19氧气目标处理试验中，共有3,654名患者被随机分配：其中1,916名（52.4%）在1年后存活，其中1,244名（64.9%）符合资格。

We assessed two preplanned 1-year outcomes: cognitive function, measured using the global score of the Repeatable Battery for the Assessment of Neuropsychological Status, and pulmonary function, evaluated as the percentage of predicted DlCO.

我们评估了两个预先计划的1年结果：认知功能，使用重复性神经心理状态评估电池的全球评分进行测量；肺功能，评估为预测的DlCO百分比。

measurements_and_main_results

A total of 417/1,244 (33.5%) eligible survivors were included, representing 11.4% of the original trial population.

共有417名（占33.5%）符合条件的幸存者被纳入研究，占原始试验人群的11.4%。

The Global Repeatable Battery for the Assessment of Neuropsychological Status score was obtained from 187 survivors in the lower oxygenation group (mean = 78; SD = 19) and 188 in the higher oxygenation group (mean = 76; SD = 21); adjusted mean difference = 2 (95% confidence interval= -2 to 6).

从低氧组的187名幸存者（平均得分=78；标准差=19）和高氧组的188名幸存者（平均得分=76；标准差=21）中获得了全球可重复神经心理状态评估电池的得分；调整后的平均差异为2（95%置信区间=-2至6）。

DlCO was measured in 192 survivors in the lower oxygenation group (mean = 68%; SD = 22) and 195 in the higher oxygenation group (mean = 73%; SD = 25); adjusted mean difference = -5 percentage points (95% CI = -9 to -1).

在低氧合组的192名幸存者中测量了DLCO（平均值=68%；标准差=22%），以及在高氧合组的195名幸存者中测量了DLCO（平均值=73%；标准差=25%）；调整后的平均差异为-5个百分点（95%置信区间=-9至-1）。

Conclusions

A PaO2 target of 60 versus 90 mm Hg appeared to result in similar cognitive impairment but might reduce pulmonary diffusion capacity in ICU survivors of hypoxemic respiratory failure included in this 1-year follow-up.Clinical trial registered with www.

在本研究的1年随访中，与90毫米汞柱相比，将PaO2目标设定为60毫米汞柱似乎导致类似的认知损害，但可能降低ICU中低氧性呼吸衰竭幸存者的肺部扩散能力。临床试验已注册于www。

clinicaltrials

gov (NCT03174002 and NCT04425031).

政府资助（NCT03174002和NCT04425031）。