LOCO2 Trial Summary: Oxygen Therapy in ARDS

LOCO2 trial ARDS oxygen

2020 2020 LOCO2 TRIAL M Liberal or conservative oxygen therapy for Acute Respiratory Distress Syndrome Multicentre, randomised controlled trial Objective: To assess whether in patients with Acute Respiratory Distress Syndrome (ARDS), does conservative (Target PaO2:55-70mmHg; SpO2: 88-92%) vs. liberal (Target PaO2:90-105mmHg; SpO2: 96%) oxygen reduce death at 28 days 201 patients Adults who were intubated and received mechanical ventilation for <12 hrs for ARDS with a PaO2:FiO2 ratio of 300 mmHg or less, at a PEEP of 5cm of water or more, < 7 days after a known clinical insult, with B/L opacities on chest imaging not fully explained by heart failure or fluid overload Conservative Oxygen (N=99) Liberal Oxygen (N=102) 02 PRIMARY OUTCOME 34.34 Death at day 28 % 95% CI, 25.0-43.7 26.47 SECONDARY OUTCOME 36.36 Death in ICU % 95% CI, 26.9-45.8 26.47 44.44 Death at day 90 % 95% CI, 34.7-54.2 30.39 23.23 Arrhythmia% 95% CI, 14.9-31.6 15.69 Conclusion: Among patients with ARDS, early exposure to a conservative-oxygenation strategy with a Pao2 between 55 and 70 mmHg did not increase survival at 28 days. L Barrot et al. NEJM 2020;382:999-1008