Abstract | BACKGROUND: METHODS: A post-hoc analysis of a nationwide multicenter prospective observational study ( ICE-CRASH study) on patients with accidental hypothermia admitted in 2019-2022 was conducted. Adult patients without cardiac arrest whose core body temperature was < 32 °C and whose arterial partial pressure of oxygen (PaO2) was measured at the emergency department were included. Hyperoxia was defined as a PaO2 level of 300 mmHg or higher, and 28-day mortality was compared between patients with and without hyperoxia before rewarming. Inverse probability weighting (IPW) analyses with propensity scores were performed to adjust patient demographics, comorbidities, etiology and severity of hypothermia, hemodynamic status and laboratories on arrival, and institution characteristics. Subgroup analyses were conducted according to age, chronic cardiopulmonary diseases, hemodynamic instability, and severity of hypothermia. RESULTS: Of the 338 patients who were eligible for the study, 65 had hyperoxia before rewarming. Patients with hyperoxia had a higher 28-day mortality rate than those without (25 (39.1%) vs. 51 (19.5%); odds ratio (OR) 2.65 (95% confidence interval 1.47-4.78); p < 0.001). IPW analyses with propensity scores revealed similar results (adjusted OR 1.65 (1.14-2.38); p = 0.008). Subgroup analyses showed that hyperoxia was harmful in the elderly and those with cardiopulmonary diseases and severe hypothermia below 28 °C, whereas hyperoxia exposure had no effect on mortality in patients with hemodynamic instability on hospital arrival. CONCLUSIONS: TRIAL REGISTRATION: The ICE-CRASH study was registered at the University Hospital Medical Information Network Clinical Trial Registry on April 1, 2019 (UMIN-CTR ID, UMIN000036132).
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Authors | Ryo Yamamoto, Jo Yoshizawa, Shuhei Takauji, Mineji Hayakawa, Junichi Sasaki |
Journal | Critical care (London, England)
(Crit Care)
Vol. 27
Issue 1
Pg. 131
(04 01 2023)
ISSN: 1466-609X [Electronic] England |
PMID | 37005646
(Publication Type: Observational Study, Multicenter Study, Journal Article)
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Copyright | © 2023. The Author(s). |
Chemical References |
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Topics |
- Adult
- Humans
- Aged
- Hypothermia
(complications)
- Hyperoxia
(complications)
- Retrospective Studies
- Hospital Mortality
- Oxygen
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