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© The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background

In septic patients, hyperoxia may help with its bactericidal effects, but it may cause systemic impairments. The role of hyperoxia and the appropriate oxygen target in these patients is unknown. The aim of this systematic review was to summarize the available literature.

Methods

We conducted a systematic search screening PubMed and Cochrane Library. Studies on adult patients with sepsis or septic shock and admitted to ICU addressing the topic of hyperoxia were included and described.

Results

We included 12 studies, for a total of 15.782 included patients. Five studies were randomized controlled trials (RCTs) or analyses from RCTs, three were prospective observational studies, and four were retrospective observational studies. The definition of hyperoxia was heterogeneous across the included studies. Mortality was the most frequent outcome: six studies showed an increased rate or risk of mortality with hyperoxia, three found no differences, and one a protective effect of hyperoxia. At the critical appraisal assessment stage, no major methodological flaws were detected, except for a single-center, pilot study, with a lack of adjustment for confounders and imbalance between the groups.

Conclusion

The optimum range of oxygen level able to minimize risks and provide benefits in patients with sepsis or septic shock seems still unknown. Clinical equipoise between hyperoxia and normoxia is uncertain as conflicting evidence exists. Further studies should aim at identifying the best range of oxygenation and its optimal duration, investigating how effects of different levels of oxygen may vary according to identified pathogens, source of infection, and prescribed antibiotics in critically ill patients with sepsis and septic shock.

Details

Title
Hyperoxia in critically ill patients with sepsis and septic shock: a systematic review
Author
Catalanotto, Francesca Romana 1 ; Ippolito, Mariachiara 2 ; Mirasola, Alice 3 ; Catalisano, Giulia 1 ; Milazzo, Marta 1 ; Giarratano, Antonino 2 ; Cortegiani, Andrea 2   VIAFID ORCID Logo 

 University of Palermo, Department of Surgical, Oncological and Oral Science (Di.Chir.On.S), Palermo, Italy (GRID:grid.10776.37) (ISNI:0000 0004 1762 5517) 
 University of Palermo, Department of Surgical, Oncological and Oral Science (Di.Chir.On.S), Palermo, Italy (GRID:grid.10776.37) (ISNI:0000 0004 1762 5517); Policlinico Paolo Giaccone, Department of Anaesthesia, Intensive Care and Emergency, Palermo, Italy (GRID:grid.412510.3) (ISNI:0000 0004 1756 3088) 
 University of Palermo, Department of Surgical, Oncological and Oral Science (Di.Chir.On.S), Palermo, Italy (GRID:grid.10776.37) (ISNI:0000 0004 1762 5517); Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy (GRID:grid.417108.b) 
Pages
12
Publication year
2023
Publication date
Dec 2023
Publisher
Springer Nature B.V.
e-ISSN
27313786
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2808788329
Copyright
© The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.