Hyperoxia toxicity in septic shock patients according to the Sepsis-3 criteria: a post hoc analysis of the HYPER2S trial

Annals of Intensive Care
Julien DemiselleHYPER2S investigators

Abstract

Criteria for the Sepsis-3 definition of septic shock include vasopressor treatment to maintain a mean arterial pressure > 65 mmHg and a lactate concentration > 2 mmol/L. The impact of hyperoxia in patients with septic shock using these criteria is unknown. A post hoc analysis was performed of the HYPER2S trial assessing hyperoxia versus normoxia in septic patients requiring vasopressor therapy, in whom a plasma lactate value was available at study inclusion. Mortality was compared between patients fulfilling the Sepsis-3 septic shock criteria and patients requiring vasopressors for hypotension only (i.e., with lactate ≤ 2 mmol/L). Of the 434 patients enrolled, 397 had available data for lactate at inclusion. 230 had lactate > 2 mmol/L and 167 ≤ 2 mmol/L. Among patients with lactate > 2 mmol/L, 108 and 122 were "hyperoxia"- and "normoxia"-treated, respectively. Patients with lactate > 2 mmol/L had significantly less COPD more cirrhosis and required surgery more frequently. They also had higher illness severity (SOFA 10.6 ± 2.8 vs. 9.5 ± 2.5, p = 0.0001), required more renal replacement therapy (RRT), and received vasopressor and mechanical ventilation for longer time. Mortality rate at day 28 was higher in the "hyperoxia"-treate...Continue Reading

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Citations

Sep 13, 2019·American Journal of Respiratory and Critical Care Medicine·Edward PalmerSteve Harris
Jan 24, 2020·The FEBS Journal·Tineke VanderhaeghenClaude Libert
Nov 23, 2019·Surgical Infections·Vanessa P HoTanya L Zakrison
Feb 16, 2020·Biomolecules·David De BelsCostantino Balestra
Sep 10, 2020·Frontiers in Medicine·Tamara MerzOscar McCook
Nov 28, 2019·Intensive Care Medicine·Anders PernerManu Shankar-Hari
Sep 10, 2021·BMC Pulmonary Medicine·Andrew J BoyleDaniel F McAuley
Jun 5, 2021·American Journal of Respiratory and Critical Care Medicine·Chad H HochbergRoy G Brower
Jul 22, 2021·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Benjamin PopoffThomas Clavier

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Clinical Trials Mentioned

NCT01722422

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