Safety of Lower Oxygenation Targets for Patients with Acute Respiratory Distress Syndrome

A recent study showed no benefit or harm from a conservative oxygen strategy that maintained oxygen saturation at <97% (NEJM JW Gen Med Dec 15 2019 and N Engl J Med 2019 Oct 14; [e-pub]). However, this target did not seem particularly conservative to many clinicians.

Investigators in France randomized patients with acute respiratory distress syndrome (ARDS) to either a target partial pressure of oxygen (PaO₂) of 55 to 70 mm Hg (conservative group; saturation, 88%–92%) or a PaO₂ of 90 to 105 mm Hg (liberal group; saturation, ≥96%), for the first 7 days of treatment; three quarters of patients had moderately severe ARDS. The trial was stopped early due to safety concerns after 205 patients were enrolled. Although higher mortality in the conser…