Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Excursion into mathematics

xvi, 489 p.; 23 cm

Oral History Interview, Anatole Beck (1057)

In these interviews, Anatole Beck discusses his work and activism throughout his life. He also talks in length about his his work in the field of mathematics that challenged the field at the time. To learn more about this oral history, download & review the index first (or transcript if available). It will help determine which audio file(s) to download & listen to.In his two September 2009 interviews with Bob Lange, Anatole Beck talks about his work and activism from the 1950s to the late 2000s. Beck chronicled his family background and education which influenced the development of his independent personality. He detailed elements of his work in mathematics that had challenged the field, and provided some anecdotes about his students and colleagues. He further explained his motivation for becoming an activist during the late 1960s and his efforts to maintain faculty governance at the University of Wisconsin-Madison. He provided insights on unionization, the “knowledge business,” national employment policy, the Vietnam era protests, and the UW-WSU Merger. This interview was conducted for inclusion into the UW-Madison Oral History Program