Reply to: "Hyperoxemia in postsurgical sepsis/septic shock patients is associated with reduced mortality"

• Published in: Critical care (London, England) Vol. 26; no. 1; p. 172
• Main Authors: Franciosi, Alessandro N, McCarthy, Cormac, MacRedmond, Ruth
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 09-06-2022; BioMed Central; BMC
• Subjects: Artificial respiration; Complications and side effects; Correspondence; Critical care; Hospital Mortality; Humans; Hypotheses; Hypoxia; Intensive care; Lung diseases; Mortality; Neutrophils; Oxygen therapy; Patient outcomes; Regression analysis; Risk factors; Sepsis; Sepsis - mortality; Shock, Septic - mortality; Surgery; Systematic review; Ventilators; Canada
• ISSN: 1364-8535; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-022-03989-z

Table S1), significant differences were demonstrated, many of which do not appear to have been included in the final multivariate models, including the significantly higher rate of chronic lung disease (22.3% vs 12.5%, p = 0.005), respiratory sepsis (73% vs 33%, p < 0.001) and septic shock (84.0% vs 67.1%, p < 0.001) in the normoxemia group. [...]details regarding the differences in the proportion and severity of ARDS between groups are lacking. [...]it is important to point out that stratification based on PaO2 formed the basis of this post-hoc analysis of an observational study, but to our understanding the same PaO2 measurements were not the result of pre-specified oxygen titration strategies, randomized to achieve dichotomized target PaO2 ranges. [...]though the authors state in the introduction that their study might help to “test the hypothesis that hyperoxemia would improve outcome compared to conservative oxygen therapy in patients with sepsis/septic shock” such a hypothesis cannot be tested by this study design. The variables considering “time function”, such as mechanical ventilation, ICU and hospital stay, were considered not to be mixed with variables of admission day. [...]Table 1 just compares patients with PaO2 ≤ 100 mmHg versus PaO2 > 100 mmHg.