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

Syskonupplevelser : att växa upp med ett syskon som har diagnos Aspergers syndrom

Title: Sibling experiences – to grow up with a sibling with Asperger syndromAuthors: Anna-Lena Hedlund and Monica OlofssonKey words: Asperger, siblings, relations, support To grow up with a sibling diagnosed with Asperger syndrome may differ from what is considered as normal. It can be challenging, but also instructive in some ways. This study examines how it is experienced by the siblings with no diagnosis. The aim is also to investigate how many of them who acquired some kind of support or, if not, would have wished that.Qualitative data are collected by means of five interviews with non-diagnosed siblings. The interview persons are in the age range of 16 to 27 and of both sexes.The result of the study demonstrates that it is an exception rather than a rule that siblings are asked if they are in need of support or information from BUP or school. Most of them had managed it fine by themselves and by support from the family, but not all families have that kind of awareness in their relations.The respondents mainly did not experience many problems for themselves, they were more worried about the sibling’s problems and how they would manage their lives in the future