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Emergency department hyperoxia is associated with increased mortality in mechanically ventilated patients: a cohort study

Overview of attention for article published in Critical Care, January 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#47 of 6,020)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

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361 tweeters
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14 Facebook pages

Readers on

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162 Mendeley
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Title
Emergency department hyperoxia is associated with increased mortality in mechanically ventilated patients: a cohort study
Published in
Critical Care, January 2018
DOI 10.1186/s13054-017-1926-4
Pubmed ID
Authors

David Page, Enyo Ablordeppey, Brian T. Wessman, Nicholas M. Mohr, Stephen Trzeciak, Marin H. Kollef, Brian W. Roberts, Brian M. Fuller

Abstract

Providing supplemental oxygen is fundamental in the management of mechanically ventilated patients. Increasing amounts of data show worse clinical outcomes associated with hyperoxia. However, these previous data in the critically ill have not focused on outcomes associated with brief hyperoxia exposure immediately after endotracheal intubation. Therefore, the objectives of this study were to evaluate the impact of isolated early hyperoxia exposure in the emergency department (ED) on clinical outcomes among mechanically ventilated patients with subsequent normoxia in the intensive care unit (ICU). This was an observational cohort study conducted in the ED and ICUs of an academic center in the USA. Mechanically ventilated normoxic (partial pressure of arterial oxygen (PaO2) 60-120 mm Hg) ICU patients with mechanical ventilation initiated in the ED were studied. The cohort was categorized into three oxygen exposure groups based on PaO2 values obtained after ED intubation: hypoxia, normoxia, and hyperoxia (defined as PaO2 < 60 mmHg, PaO2 60-120 mm Hg, and PaO2 > 120 mm Hg, respectively, based on previous literature). A total of 688 patients were included. ED normoxia occurred in 350 (50.9%) patients, and 300 (43.6%) had exposure to ED hyperoxia. The ED hyperoxia group had a median (IQR) ED PaO2 of 189 mm Hg (146-249), compared to an ED PaO2 of 88 mm Hg (76-101) in the normoxia group, P < 0.001. Patients with ED hyperoxia had greater hospital mortality (29.7%), when compared to those with normoxia (19.4%) and hypoxia (13.2%). After multivariable logistic regression analysis, ED hyperoxia was an independent predictor of hospital mortality (adjusted OR 1.95 (1.34-2.85)). ED exposure to hyperoxia is common and associated with increased mortality in mechanically ventilated patients achieving normoxia after admission. This suggests that hyperoxia in the immediate post-intubation period could be particularly injurious, and targeting normoxia from initiation of mechanical ventilation may improve outcome.

Twitter Demographics

The data shown below were collected from the profiles of 361 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 162 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 162 100%

Demographic breakdown

Readers by professional status Count As %
Other 25 15%
Student > Master 17 10%
Researcher 16 10%
Student > Postgraduate 16 10%
Professor > Associate Professor 10 6%
Other 42 26%
Unknown 36 22%
Readers by discipline Count As %
Medicine and Dentistry 84 52%
Nursing and Health Professions 14 9%
Engineering 4 2%
Unspecified 2 1%
Agricultural and Biological Sciences 2 1%
Other 6 4%
Unknown 50 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 242. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 April 2022.
All research outputs
#124,967
of 22,611,748 outputs
Outputs from Critical Care
#47
of 6,020 outputs
Outputs of similar age
#3,341
of 406,165 outputs
Outputs of similar age from Critical Care
#1
of 10 outputs
Altmetric has tracked 22,611,748 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,020 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 19.0. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 406,165 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 10 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them