Higher vs. lower oxygenation targets in Covid-19 (HOT-COVID trial)
Published in January 2021, the HOT-ICU trial found no difference in mortality (42.9% vs 42.4%) among 2928 hypoxemic patients in European ICUs receiving at least 10L/min oxygen, regardless of whether they were randomized to a high (PaO2 90 mmHg) or low (PaO2 60 mmHg) oxygenation target. Nor were there any significant between-group differences in need for life support or other clinical outcomes.
HOT-ICU enrolled patients with diverse illnesses, but a post-hoc analysis of that trial found that patients with Covid-19 had lesser needs for life support when randomized to a lower oxygenation target.
Some of the same authors now report the results of the much-smaller follow up study (HOT-COVID), concluding that lower oxygenation targets may in fact be beneficial in patients with Covid-19 pneumonia.
Investigators randomized 697 patients with Covid-19 receiving at least 10L/min of oxygen at ICUs in 5 European countries to either a higher (PaO2 90 mmHg) or lower (PaO2 60 mmHg) oxygenation target…
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