• Gareth A L Jones, Martin Wiegand, Samiran Ray, Doug W Gould, Rachel Agbeko, Elisa Giallongo, Walton N Charles, Marzena Orzol, Lauran O'Neill, Lamprini Lampro, Jon Lillie, John Pappachan, Padmanabhan Ramnarayan, David A Harrison, Paul R Mouncey, Mark J Peters, and Oxy-PICU Investigators of the Pediatric Critical Care Society Study Group.
• Paediatric ICU, Great Ormond Street Hospital for Children NHS Foundation Trust and NIHR Biomedical Research Centre, London, United Kingdom.
• Pediatr Crit Care Me. 2024 Oct 1; 25 (10): 912917912-917.

ObjectivesA conservative oxygenation strategy, targeting peripheral oxygen saturations (Sp o2 ) between 88% and 92% in mechanically ventilated children in PICU, was associated with a shorter duration of organ support and greater survival compared with Sp o2 greater than 94% in our recent Oxy-PICU trial. Sp o2 monitors may overestimate arterial oxygen saturation (Sa o2 ) in patients with higher levels of skin pigmentation compared with those with less skin pigmentation. We investigated if ethnicity was associated with changes in distributions of Sp o2 and F io2 and outcome.DesignPost-hoc analysis of a pragmatic, open-label, multicenter randomized controlled trial.SettingFifteen PICUs across the United Kingdom and Scotland.PatientsChildren aged 38 weeks corrected gestational age to 15 years accepted to a participating PICU as an unplanned admission and receiving invasive mechanical ventilation with supplemental oxygen for abnormal gas exchange.MethodsHierarchical regression models for Sp o2 and F io2 , and ordinal models for the primary trial outcome of a composite of the duration of organ support at 30 days and death, were used to examine the effects of ethnicity, accounting for baseline Sp o2 , F io2 , and mean airway pressure and trial allocation.Measurements And Main ResultsEthnicity data were available for 1577 of 1986 eligible children, 1408 (89.3%) of which were White, Asian, or Black. Sp o2 and F io2 distributions did not vary according to Black or Asian ethnicity compared with White children. The trial primary outcome measure also did not vary significantly with ethnicity. The point estimate for the treatment effect of conservative oxygenation in Black children was 0.64 (95% CI, 0.33-1.25) compared with 0.84 (0.68-1.04) in the overall trial population.ConclusionsThese data do not suggest that the association between improved outcomes and conservative oxygenation strategy in mechanically ventilated children in PICU is modified by ethnicity.Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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