6/28/23, 11:01 PM LOCO2 Pathway Feedback Search Clinical Topics Home Studies LOCO2 LOCO2 Disease Acute respiratory distress syndr Trial question Is conservative oxygenation strategy superior to liberal oxygenation strategy in patients with ARDS? Study design Multi-center Open label RCT Population Characteristics of study participants 36.0% female N = 201 64.0% male 201 patients (72 female, 129 male) Inclusion criteria: patients who had undergone intubation and had been receiving mechanical ventilation for < 12 hours for ARDS Key exclusion criteria: long-term oxygen therapy or noninvasive ventilation at home; hospitalization for cardiac arrest, TBI, or cranial hypertension Interventions N=99 a conservative oxygen strategy (target partial pressure of arterial oxygen between 55 and 70 mmHg; oxygen saturation as measured by pulse oximetry between 88 and 92% for 7 days) N=102 a liberal oxygen strategy (target partial pressure of arterial oxygen of 90 to 105 mmHg; oxygen saturation as measured by pulse oximetry 96% for 7 days) https://web.pathway.md/studies/recVUDlA5djtrmksE 1/2 6/28/23, 11:01 PM LOCO2 Pathway Primary outcome Death at 28 days 34.3 % 34.3 26.5 25.7 % 17.1 % 8.6 % No significant difference 0.0 % A conservative oxygen strategy A liberal oxygen strategy No significant difference in death at 28 days (34.3% vs. 26.5%; AD 7.8%, 95% CI -4.8 to 20.6) Secondary outcomes Significant increase in death at 90 days (44.4% vs. 30.4%; AD 14%, 95% CI 0.7 to 27.2) Safety outcomes No significant differences in infections, mechanical ventilation, seizure or delirium. Significant difference in mesenteric ischemia (5.1% vs. 0%). Conclusion In patients who had undergone intubation and had been receiving mechanical ventilation for < 12 hours for ARDS, a conservative oxygen strategy was not superior to a liberal oxygen strategy with respect to death at 28 days. Reference Loic Barrot, Pierre Asfar, Frederic Mauny et al. Liberal or Conservative Oxygen Therapy for Acute Respiratory Distress Syndrome. N Engl J Med. 2020 Mar 12;382(11):999-1008. Open reference URL https://web.pathway.md/studies/recVUDlA5djtrmksE 2/2