Hyperoxemia by prehospital supplemental oxygen in polytrauma patients: less ain’t more.

Henstra, L. (2015) Hyperoxemia by prehospital supplemental oxygen in polytrauma patients: less ain’t more. thesis, Medicine.

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Abstract

Background: Recently, more and more studies are published concerning the overuse of oxygen in various medical emergencies. These studies suggest that generous use of oxygen could have detrimental side-effects. Research in trauma patients concerning this matter is scarce, whereas more clarity about the effects of pre-hospital supplemental oxygen therapy in trauma patients may have profound implications for pre-hospital trauma care in general. Aim: This study aims to investigate whether pre-hospital supplemental oxygen therapy affects mortality in patients with multiple trauma. Hypothesis: Hyperoxemia by pre-hospital oxygen administrations has an adverse effect on survival rate in patients with multiple trauma. Results: A total of 1691 patients were included, and accounted for 4980 blood samples on different time intervals. The course of PaO2 in patients who survived significantly differed from the course of PaO2 in patients who deceased (p <0.001). The initial significant relationship between PaO2 and mortality (p <0.001) became insignificant after adjustment for injury severity and vital parameters (p 0.563). Conclusion: The significant relationship between PaO2 and mortality disappears when data is adjusted for various potential confounders. This suggests that hyperoxemia in patients with multiple trauma is most likely an indicator of illness severity, and hyperoxemia itself is not a cause of mortality. Adjusting data only for age, gender and NISS is not enough to rule out relevant confounders. Data should also be adjusted for vital parameters and other indicators of illness severity, since these turned out to be confounders as well. This study does not support the excessive use of oxygen but shows that any possible scepticism in the use of oxygen, which may have been triggered by previous studies, is probably unnecessary.

Item Type:	Thesis (Thesis)
Supervisor name:	el Moumni, drs. M.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:57
Last Modified:	25 Jun 2020 10:57
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1755

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