Conservative versus liberal oxygenation targets in critically ill children: the randomised multiple-centre pilot Oxy-PICU trial

Abstract

A definitive clinical trial of peripheral oxygen saturation targets is feasible in critically ill children.

Focus on paediatrics

“…The outcome of a pilot RCT is the feasibility of undertaking the multi-centre RCT at scale, including necessary sample size data. The pilot trials for conservative versus liberal oxygenation targets in critically ill children (oxy-PICU) [17] and high flow nasal cannula oxygen versus CPAP (first ABC) [18], represent 'for runners' to multi centre RCT starting in 2019.…”

Focus on paediatrics 2018

“…However, there is a lack of data about the safety of oxygen therapy. Since then, Oxy-PICU investigators have reported the results of a pilot randomised trial comparing conservative (88-92%) versus liberal (> 94%) SpO 2 targets in ventilated children receiving supplemental oxygen [3]. The results showed that a conservative oxygen target appeared safe and that a definitive trial was feasible.…”

A COASTal view: where prior beliefs and uncertainty collide

“…Perhaps the most striking result in this stratum was that mortality amongst the permissive hypoxaemia group was the same as for those given low-flow oxygen. Given the recent results of the Higher or Lower Oxygenation Targets for Acute Hypoxaemia Respiratory Failure (HOT-ICU), [1] Conservative Oxygen Therapy during Mechanical Ventilation in the ICU (ICU-ROx) [2] and Conservative versus liberal oxygenation targets pilot trial in critically ill children (Oxy-PICU) [3], this is perhaps the result we would now expect, but this was far from certain when COAST was first planned. This finding has important implications for oxygen use which is a scarce resource in this setting.…”