title: Hyperoxemia and long-term outcome after traumatic brain injury.
abstract: BACKGROUND
  The relationship between hyperoxemia and outcome in patients with traumatic brain injury (TBI) is controversial. We sought to investigate the independent relationship between hyperoxemia and long-term mortality in patients with moderate-to-severe traumatic brain injury.
  
  
  METHODS
  The Finnish Intensive Care Consortium database was screened for mechanically ventilated patients with a moderate-to-severe TBI. Patients were categorized, according to the highest measured alveolar-arterial O₂ gradient or the lowest measured PaO₂ value during the first 24 hours of ICU admission, to hypoxemia (<10.0 kPa), normoxemia (10.0 to 13.3 kPa) and hyperoxemia (>13.3 kPa). We adjusted for markers of illness severity to evaluate the independent relationship between hyperoxemia and 6-month mortality.
  
  
  RESULTS
  A total of 1,116 patients were included in the study, of which 16% (n = 174) were hypoxemic, 51% (n = 567) normoxemic and 33% (n = 375) hyperoxemic. The total 6-month mortality was 39% (n = 435). A significant association between hyperoxemia and a decreased risk of mortality was found in univariate analysis (P = 0.012). However, after adjusting for markers of illness severity in a multivariate logistic regression model hyperoxemia showed no independent relationship with 6-month mortality (hyperoxemia vs. normoxemia OR 0.88, 95% CI 0. 63 to 1.22, P = 0.43; hyperoxemia vs. hypoxemia OR 0.97, 95% CI 0.63 to 1.50, P = 0.90).
  
  
  CONCLUSIONS
  Hyperoxemia in the first 24 hours of ICU admission after a moderate-to-severe TBI is not predictive of 6-month mortality.
authors: Rahul
authors: R
authors: Raj
authors: Stepani
authors: S
authors: Bendel
authors: Matti
authors: M
authors: Reinikainen
authors: Riku
authors: R
authors: Kivisaari
authors: Jari
authors: J
authors: Siironen
authors: Maarit
authors: M
authors: Lång
authors: Markus
authors: M
authors: Skrifvars
mesh_terms: D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis / Q000379:methods / Q000639:trends; D001930:Brain Injuries / Q000378:metabolism / Q000401:mortality* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units / Q000639:trends*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects* / Q000379:methods / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
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