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

Book review: Southeast Asia in Ruins: Art and Empire in the Early 19th Century

2016 was the 200th anniversary of the British returning Java to the Dutch after the Napoleonic Wars. It also saw the first major scholarly publications on early nineteenth century British colonialism in Southeast Asia since the 1990s: Farish Noors’ The Discursive Construction of Southeast Asia in 19th-Century Colonial- Capitalist Discourse, Gareth Knapman’s Race and British Colonialism in Southeast Asia, and the subject of this review, Sarah Tiffin’s lavishly presented Southeast Asia in Ruins

Book Review: Anthropologists in the Stock Exchange: a Financial History of Victorian Science

There is a noticeable trend towards intrigue in recent writing on the history of British anthropological societies. Ter Ellingson’s Myth of the Noble Savage, a search for the inventor of the term, is a glaring example of conspiracy as history writing, but Adrian Desmond and James Moore’s Sacred Curse, although much more nuanced, also focused on the power play behind 19thcentury science. Marc Flandreau’s Anthropologists in the Stock Exchange resembles Ellingson’s conspiracies, rather than Desmond and Moore’s careful scholarshi

The art of Conciliation

The conciliation was an agreement that brought an end to 'The Black War' between settlers and the Palawa (Aboriginal people) of Van Diemen's Land. It saw the Palawa cease their resistance and accept government protection, Christianity and a reservation of land on Flinders Island

Settler colonialism and usurping Malay sovereignty in Singapore

This article proposes that Singapore should be considered as a settler colony during its first years of settlement. The first Residents, William Farquhar, Thomas Stamford Raffles and John Crawfurd all attempted to build Singapore as a settler colony, similar to those in Australia and North America. The difference was, however, that they looked to attract Chinese, Malay and Indian settlers as well as Europeans. By viewing Singapore as a settler colony, this article reinterprets our understanding of who constitutes a settler within settler colonial frameworks. It concludes that settler colonialism was not directly about moving indigenous people off the land, but rather establishing a new system of sovereignty in which individuals (regardless of race) were allowed to own land and become settlers. Nevertheless, the actions of the settlers and the British authorities created violent tensions with the original Malay inhabitants that were only resolved by the transfer of sovereignty from Sultan Hussein to the East India Company

Race, polygenesis and equality: John Crawfurd and nineteenth-century resistance to evolution

The nineteenth-century Orientalist and ethnologist, John Crawfurd, publicly rejected Charles Darwin’s theory of evolution in 1868. Crawfurd was a leading advocate of polygenesis but also a supporter of racial equality. In 1820 he published his History of the Indian Archipelago, where he advocated granting household suffrage to all races in the British colonies. After finishing a career in the East India Company in 1828 he became the foremost expert on South-East Asia in Britain. Crawfurd became a regular writer on ethnology and Asian affairs for the Examiner newspaper and in the 1860s he was President of the Ethnological Society of London. Accounts of nineteenth-century anthropology in Britain characterise debate around race as falling into two camps: advocates of monogenesis and advocates of polygenesis. In the United States of America, advocates of polygenesis were often associated with advocates of slavery and racial inequality. Recent research has demonstrated that Charles Darwin’s hatred of slavery drove him to write Origin of the Species to demonstrate the unity of the human species and reject the polygenesis position. This paper explores Crawfurd’s ideas and demonstrates that a belief in polygenesis in the nineteenth century did not necessarily equate with a belief in racial inequality

Race and British Colonialism in Southeast Asia, 1770-1870: John Crawfurd and the politics of equality

This important series examines a diverse range of imperial histories from the early modern period to the twentieth century. Drawing on works of political, social, economic and cultural history, the history of science and political theory, the series encourages methodological pluralism and does not impose any particular conception of historical scholarship. While focused on particular aspects of empire, works published also seek to address wider questions on the study of imperial history