Provision of invasive mechanical ventilation is required for most critically ill patients admitted to an intensive care unit (ICU). Delivery of supplemental oxygen to ICU patients receiving mechanical ventilation often exposes them to a high fraction of inspired oxygen (FIO2) and higher than normal arterial oxygen partial pressure (PaO2). Humans are adapted to breathe air and it is plausible exposure to higher amounts of oxygen, either PaO2, FIO2, or both, might be harmful. Despite this, the optimal oxygen regimen in critically ill patients remains uncertain. This talk will focus on existing evidence around oxygen therapy mechanically ventilated ICU patients and on the design of the Mega-ROX trial, 40000 patient RCT comparing conservative oxygen therapy and liberal oxygen therapy, which has recently begun enrolling patients.
By the end of this lecture, the attendee will be able to:
- Describe the potential biological basis for harm associated with liberal oxygen therapy in mechanically ventilated adults who are critically ill.
- Explain the findings of the ICU-ROX trial.
- Summarise evidence from other randomised controlled trials evaluating oxygen therapy in the ICU.
- Outline the key design features of the Mega-ROX trial.
This lecture is equal to 1 CE Contact Hour, 1 CPD Point, and 1 AMA PRA Category 1 Credit™
Additional CME Info
Release Date: February 1, 2020, Termination Date: January 31, 2023
Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of EB Medicine and Continulus. EB Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation: EB Medicine designates this internet enduring material for a maximum of 1 AMA PRA Category 1 Credit™ per lecture. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Commercial Support: This activity received no commercial support.
Earning Credit: In order to earn CME credit, the participant must take the pre-test, listen to the lecture, take the CME post-test, and complete the post-test evaluation.
Duration 1 hour(s).
Dr. Paul Young
Dr. Paul Young is a key member of the highly successful Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) and leading member of the New Zealand ICU research community. His primary interest is in the design and conduct of large-scale multi centre randomised controlled trials in the field of Intensive Care Medicine. Dr. Young is Associate Editor for Critical Care and Resuscitation (the highest impact journal in the field of Intensive Care Medicine outside the US and Europe). Dr. Young has more than 150 publications, including in the New England Journal of Medicine, the Lancet, and JAMA. He is currently involved in collaborations with researchers from Australia, Canada, the USA, the UK, Europe, and Brazil. Prior to attending medical school, Dr. Young completed a BSc (Hons) at Victoria University of Wellington. He went on to study medicine at the University of Auckland. Dr. Young completed most of his Intensive Care Specialist training in Melbourne, before returning to Wellington where he has worked as an Intensive Care Specialist since 2010. In 2016 he also completed a PhD in clinical research. He is currently the Deputy Director of the Medical Research Institute of New Zealand (MRINZ). In addition to his MRINZ role, Dr. Young is the co-clinical leader at Wellington ICU and the medical director at Wakefield Hospital ICU.
CME Faculty Disclosure: It is the policy of EB Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. In compliance with all ACCME Essentials, Standards, and Guidelines, all faculty for this CME activity were asked to complete a full disclosure statement. The speaker did not report any relevant financial interest or other relationship with the manufacturer(s) of any commercial product(s) discussed in this educational presentation.