• E P Gomes, M M Reboredo, G B Costa, F S Barros, E V Carvalho, and B V Pinheiro.
• Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
• Med Intensiva. 2023 Apr 1; 47 (4): 212220212-220.

ObjectiveWe examined weather a protocol for fraction of inspired oxygen (FiO2) adjustment can reduce hyperoxemia and excess oxygen use in COVID-19 patients mechanically ventilated.DesignProspective cohort study.SettingTwo intensive care units (ICUs) dedicated to COVID-19 patients in Brazil.PatientsConsecutive patients with COVID-19 mechanically ventilated.InterventionsOne ICU followed a FiO2 adjustment protocol based on SpO2 (conservative-oxygen ICU) and the other, which did not follow the protocol, constituted the control ICU.Main Variables Of InterestPrevalence of hyperoxemia (PaO2 >100 mmHg) on day 1, sustained hyperoxemia (present on days 1 and 2), and excess oxygen use (FiO2 > 0.6 in patients with hyperoxemia) were compared between the two ICUs.ResultsEighty two patients from the conservative-oxygen ICU and 145 from the control ICU were included. The conservative-oxygen ICU presented lower prevalence of hyperoxemia on day 1 (40.2% vs. 75.9%, p < 0.001) and of sustained hyperoxemia (12.2% vs. 49.6%, p < 0.001). Excess oxygen use was less frequent in the conservative-oxygen ICU on day 1 (18.3% vs. 52.4%, p < 0.001). Being admitted in the control ICU was independently associated with hyperoxemia and excess oxygen use. Multivariable analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FiO2 use and adverse clinical outcomes.ConclusionsFollowing FiO2 protocol was associated with lower hyperoxemia and less excess oxygen use. Although those results were not associated with better clinical outcomes, adopting FiO2 protocol may be useful in a scenario of depleted oxygen resources, as was seen during the COVID-19 pandemic.© 2022 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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