No Benefit to Targeting a Lower Partial Pressure of Oxygen

Oxygen is a life-saving intervention for patients with hypoxemic respiratory failure. However, might too much oxygen be harmful? Although small studies have suggested a benefit for lower oxygenation targets, a conservative oxygen strategy did not result in earlier extubation or lower mortality in a previous trial of nearly 1000 patients (NEJM JW Gen Med Dec 15 2019 and N Engl J Med 2020; 382:989).

Now, European investigators randomized 2888 patients with hypoxemic respiratory failure to a partial pressure of arterial oxygen (PaO₂) target of either 60 mm Hg or 90 mm Hg. More than half of patients had pneumonia; 13% had acute respiratory distress syndrome. Hypoxemia was moderately severe, with median ratio of PaO₂ to fraction of inspired oxyge…