Loading ...

TOPLINE:

Only 5% of patients with trauma experienced significant hypoxemia within the first 8 hours of care, with no difference observed between restrictive and liberal oxygen strategies.

METHODOLOGY:

• This substudy of the randomized TRAUMOX2 trial included 60 adults with trauma injury (median age, 49 years; 75% men) who were randomly assigned to receive either a restrictive or liberal oxygen therapy during the first 8 hours after trauma in Denmark.
• Eligible patients had blunt or penetrating trauma and were expected to stay in the hospital for > 24 hours. Patients with carbon monoxide poisoning or cardiac arrest before randomization were excluded.
• The primary outcome was hypoxemia, defined as having arterial oxygen saturation of < 90% for at least 5 minutes, measured using continuous pulse oximetry.
• The median continuous monitoring time was 6.9 hours.

TAKEAWAY:

• A total of 5% patients experienced at least one episode of hypoxemia.
• These episodes occurred during initial resuscitation in the trauma resuscitation room in two patients and in the intensive care unit following a thoracic procedure in one patient.
• The liberal oxygen group experienced slightly longer episodes of hypoxemia than the restrictive oxygen group (median difference per episode, 2 seconds; P = .008), but no other differences were found between the groups.

IN PRACTICE:

"These findings suggest that, among trauma patients not already requiring continuous monitoring, such episodes of hypoxemia are relatively rare in the early post-trauma period," the authors of the study wrote.

SOURCE:

This study was led by Oscar Rosenkrantz, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. It was published online on March 18, 2025, in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

LIMITATIONS:

This study enrolled patients mostly during regular working hours and from only two sites, limiting the generalizability of its findings. Key data on oxygen titration and treatment responses were poorly documented. The exclusion of patients with brief monitoring and baseline differences between groups may have introduced bias. The trial setting and the presence of unmuted alarms may have influenced clinician behavior, potentially underestimating the incidence of hypoxemia. Additionally, the small sample size may have limited the power to detect differences between groups.

DISCLOSURES:

This study was funded by the Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. The TRAUMOX2 trial was funded by grants from the Novo Nordisk Foundation, Joint Research Fund of Odense University Hospital and Rigshospitalet, and Lundbeck Foundation. One author reported receiving the Talented Young Researcher prize from the Lundbeck Foundation, with some of the prize money spent on the TRAUMOX2 trial. Several authors reported receiving funding from various sources. Details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.