The Impact of Conservative Oxygen Therapy on Mortality Among Critically Ill Adult Patients in Comparison to Liberal Oxygen Therapy

Abstract

Background: Liberal Oxygen Therapy (LOT) has the potential to prevent hypoxemia/hypoxia, but it can also cause hyperoxemia/hyperoxia, which can result in oxygen toxicity, infection and increased mortality rates. Although hyperoxia and hyperoxemia have been associated with a variety of potential adverse effects, most clinical practices advocate for the prompt and unmonitored delivery of high-concentration oxygen therapy to critically ill patients. Conservative Oxygen Therapy (COT) is the administration of less supplemental oxygen to patients, resulting in a reduced level of arterial oxygenation. This strategy attempts to reduce the risk of oxygen toxicity by limiting a patient's exposure to excessive oxygen.

Aim: This systematic literature search and structured literature review aimed to determine the impact of COT on mortality among critically ill adult patients in comparison to LOT.

Methods: Four electronic databases, including Embase, PubMed, CINAHL (EBSCOhost) and Cochrane Library, were utilised to conduct a systematic search for quantitative studies comparing the effectiveness of COT to LOT from the last ten years up to June 2023. The search was conducted using a substantive list of keywords, related terms and predetermined inclusion and exclusion criteria.

Results: A comprehensive search was conducted and an automated tool was utilised, thereby resulting in the identification of 2060 studies. Duplicates were eliminated using EndNote software. Subsequently, a comprehensive screening process was conducted on 1571 studies, which included the evaluation of their titles, abstracts and full texts. This rigorous assessment strictly adhered to the predetermined criteria established for inclusion. A comprehensive systematic search yielded nine studies that were included in the dissertation.

Conclusion: In comparing the COT to the LOT, there was no observed reduction in mortality rates among critically ill patients; however, ongoing studies have the potential to yield accurate and trustworthy results.