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Higher versus lower fractions of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit
CONCLUSIONS: In adult ICU patients, it is still not possible to draw clear conclusions about the effects of higher versus lower oxygenation strategies on all-cause mortality, SAEs, quality of life, lung injuries, myocardial infarction, stroke, and sepsis at maximum follow-up. This is due to low or very low-certainty evidence.PMID:37700687 | DOI:10.1002/14651858.CD012631.pub3
Source: Cochrane Database of Systematic Reviews - September 13, 2023 Category: General Medicine Authors: Thomas L Klitgaard Olav L Schj ørring Frederik M Nielsen Christian S Meyhoff Anders Perner J ørn Wetterslev Bodil S Rasmussen Marija Barbateskovic Source Type: research

Higher versus lower fraction of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit.
CONCLUSIONS: We are very uncertain about the effects of higher versus lower fraction of inspired oxygen or targets of arterial oxygenation for adults admitted to the ICU on all-cause mortality, serious adverse events, and lung injuries at the time point closest to three months due to very low-certainty evidence. Our results indicate that oxygen supplementation with higher versus lower fractions or oxygenation targets may increase mortality. None of the trials reported the proportion of participants with one or more serious adverse events according to the ICH-GCP criteria, however we found that the trials reported an increa...
Source: Cochrane Database of Systematic Reviews - November 26, 2019 Category: General Medicine Authors: Barbateskovic M, Schjørring OL, Russo Krauss S, Jakobsen JC, Meyhoff CS, Dahl RM, Rasmussen BS, Perner A, Wetterslev J Tags: Cochrane Database Syst Rev Source Type: research

Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis
This study is registered with PROSPERO, number CRD42017065697. Findings 25 randomised controlled trials enrolled 16 037 patients with sepsis, critical illness, stroke, trauma, myocardial infarction, or cardiac arrest, and patients who had emergency surgery. Compared with a conservative oxygen strategy, a liberal oxygen strategy (median baseline saturation of peripheral oxygen [SpO2] across trials, 96% [range 94–99%, IQR 96–98]) increased mortality in-hospital (relative risk [RR] 1·21, 95% CI 1·03–1·43, I 2=0%, high quality), at 30 days (RR 1·14, 95% CI 1·01–1·29, I 2=0%, high quality), and at longest follow...
Source: The Lancet - April 28, 2018 Category: General Medicine Source Type: research

Ischaemia-reperfusion injury and hyperbaric oxygen pathways: a review of cellular mechanisms.
Authors: Francis A, Baynosa R Abstract Ischaemia-induced tissue injury has wide-ranging clinical implications including myocardial infarction, stroke, compartment syndrome, ischaemic renal failure and replantation and revascularization. However, the restoration of blood flow produces a 'second hit' phenomenon, the effect of which is greater than the initial ischaemic event and characterizes ischaemia-reperfusion (IR) injury. Some examples of potential settings of IR injury include: following thrombolytic therapy for stroke, invasive cardiovascular procedures, solid organ transplantation, and major trauma resuscitat...
Source: Diving and Hyperbaric Medicine - June 24, 2017 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Pre-conditioning with low-level laser (light) therapy: light before the storm.
Abstract Pre-conditioning by ischemia, hyperthermia, hypothermia, hyperbaric oxygen (and numerous other modalities) is a rapidly growing area of investigation that is used in pathological conditions where tissue damage may be expected. The damage caused by surgery, heart attack, or stroke can be mitigated by pre-treating the local or distant tissue with low levels of a stress-inducing stimulus, that can induce a protective response against subsequent major damage. Low-level laser (light) therapy (LLLT) has been used for nearly 50 years to enhance tissue healing and to relieve pain, inflammation and swelling. The p...
Source: Dose Response - December 1, 2014 Category: Drugs & Pharmacology Authors: Agrawal T, Gupta GK, Rai V, Carroll JD, Hamblin MR Tags: Dose Response Source Type: research

In search of a treatment for radiation-induced optic neuropathy
Opinion statement Radiation-induced optic neuropathy (RON) is an iatrogenic complication that causes severe, irreversible vision loss in one or both eyes within the months to years following radiation therapy. Posterior RON is a rare but devastating toxicity of radiation applied to the visual pathways to treat paranasal sinus and skull base tumors. Anterior RON is an unavoidable consequence of proton beam irradiation or ophthalmic plaque treatment of orbital, choroidal, or retinal tumors. Various treatments aimed at stabilizing and ideally reversing vision loss have been investigated but only in small cases serie...
Source: Current Treatment Options in Neurology - November 8, 2014 Category: Neurology Source Type: research

The medical use of oxygen: a time for critical reappraisal
Abstract Oxygen treatment has been a cornerstone of acute medical care for numerous pathological states. Initially, this was supported by the assumed need to avoid hypoxaemia and tissue hypoxia. Most acute treatment algorithms, therefore, recommended the liberal use of a high fraction of inspired oxygen, often without first confirming the presence of a hypoxic insult. However, recent physiological research has underlined the vasoconstrictor effects of hyperoxia on normal vasculature and, consequently, the risk of significant blood flow reduction to the at‐risk tissue. Positive effects may be claimed simply by relief of a...
Source: Journal of Internal Medicine - November 11, 2013 Category: Internal Medicine Authors: F. Sjöberg, M. Singer Tags: Review Source Type: research

Medical management of critical limb ischaemia: where do we stand today?
This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - June 26, 2013 Category: Internal Medicine Authors: Matthew A. Lambert, Jill J. F. Belch Tags: Review Source Type: research