A conservative oxygenation strategy is feasible and appears to be safe compared with liberal oxygenation in mechanically ventilated patients [synopsis]

of: Panwar R, Hardie M, Bellomo R, Barrot L, Eastwood GM, Young PJ, et al. Conservative versus liberal oxygenation targets for mechanically ventilated patients – a pilot multicenter randomized controlled trial. Am J Respir Crit Care Med. 2015; in press. Question: Is a conservative oxygenation strategy a feasible and safe alternative to liberal oxygenation in mechanically ventilated patients? Design: Pilot, multicentre, randomised, controlled trial with concealed allocation. Patients were blinded, but clinicians and assessors were not. Setting: Four intensive care units, located in Australia, New Zealand and France. Participants: Inclusion criteria were: being aged 18 years, receiving mechanical ventilation for < 24 hours, being expected to continue 24 hours further. Exclusion criteria included: known pregnancy, imminent risk of death, or if the treating clinician lacked equipoise for the patient to be enrolled in the trial. Randomisation of 104 participants allocated 53 to conservative oxygenation and 51 to liberal oxygenation. Interventions: Throughout the period of mechanical ventilation, the bedside nurse titrated the fraction of inspired oxygen (within 0.21 to 0.80) to achieve the specific oxygen saturation targets, measured via pulse oximeter. For the conservative oxygenation group, the oxygen saturation target was 90 to 92%. For the liberal oxygenation group, the oxygen saturation target was 96%. Positive end-expiratory pressure was adjusted as per usual practice in both groups. Outcome measures: The primary outcomes included the mean area-under-curve for several