Oxygen Therapy in the ICU

A review of the evidence

The lecture duration is 43min.

0.75 CPD Points, 0.75 CEUs, 0.75 AMA PRA Category 1 Credits.
Accredited by CPDUK, CBRN and EB Medicine.

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Paul Young
Consultant and Researcher in Intensive Care, Wellington, New Zealand
Lecture Summary

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.

Target Audience

Critical Care Doctors
Experienced or advanced Critical Care Nurses

Learning Objectives:

Upon completion of this activity, you should 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 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 .75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Needs Assessment

The need for this educational activity was determined by surveys of the target audience and experts in the specialty. Further assessment was provided by examining the topics of recently published evidence-based medicine reviews, national clinical guidelines, and specialty society recommendations, as well as suggestions from evaluations of previous learning programs to determine practice gaps.

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 accreditation requirements and policies, 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.

Earning Credit

In order to earn CME credit, the participant must take the pre-test, watch the course, take the CME post-test, and complete the post-test evaluation.

Hardware/Software Requirements

Online learners will need a computer or web-enabled device to access the podcast, additional learning materials, and CME test.

Commercial Support

This activity received no commercial support.

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