Hacker Newsnew | past | comments | ask | show | jobs | submitlogin
Mortality/morbidity: acutely ill adults liberal vs. conservative Oxygen Tx(2018) (thelancet.com)
3 points by taxicabjesus on April 27, 2020 | hide | past | favorite | 1 comment


The full title of this submission is "Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis (2018)". Hopefully my shortening to fit in the box was appropriate.

The conclusion is that excess oxygen worsens patients' outcomes:

> Interpretation

> In acutely ill adults, high-quality evidence shows that liberal oxygen therapy increases mortality without improving other patient-important outcomes. Supplemental oxygen might become unfavourable above an SpO 2 range of 94–96%. These results support the conservative administration of oxygen therapy.

I just read an essay about how a nursing home patient rapidly deteriorated after being sent to the hospital [0]. When I read between the lines, it seems the patient (who previously had a stroke, and was sent from her nursing home for evaluation) rapidly deteriorated due to being over-oxygenated at the hospital. The essayist didn't give the patients' outcome, but I'd wager the patient is now a statistic.

Many other super-virus casualties might've survived if more doctors were familiar with this study, and instead used indicated drugs to help the body use oxygen efficiently.

I read recently that ventilating patients increases the amount of work required to keep them alive by 100x. Two other recent submissions were about how less-aggressive approaches to ventilation have been somewhat more successful [2] [3].

If the doctors combine their newfound reluctance to ventilate with more conservative oxygen strategies [4], maybe the medical professionals will be able to declare a victory against this year's super-virus.

[0] When This War Is Over, Many of Us Will Leave Medicine - https://news.ycombinator.com/item?id=22992488

[2] UChicago doctors see ‘remarkable’ success using ventilator alternatives - https://news.ycombinator.com/item?id=22977076

[3] As virus advances, doctors rethink rush to ventilate - https://news.ycombinator.com/item?id=22955094

[4] https://en.wikipedia.org/wiki/Oxygen_toxicity#Mechanism

[minor edits & added titles to [2] and [3]]




Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: